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General NPI Number Information
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NPI Number | 1871280362
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Entity Type | Individual
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Provider Name | JOSHUA GRANT GRAY
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Gender | Male
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 2302 COLLEGE AVE
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City | CONWAY
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State | AR
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Zip | 72034-6297
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Country | US
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Telephone | 501-513-5385
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Fax |
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Provider Business Mailing Address
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Address Line | 2302 COLLEGE AVE
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City | CONWAY
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State | AR
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Zip | 72034-6297
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E-19907
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License Number State | AR
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