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General NPI Number Information
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NPI Number | 1932381753
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Entity Type | Organization
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Legal Business Name | DEBRA A. GRAYSON, D.O., INC.
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 4677 E MAIN ST
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City | COLUMBUS
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State | OH
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Zip | 43213-3160
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Country | US
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Telephone | 614-575-6270
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Fax | 614-575-6282
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Provider Business Mailing Address
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Address Line | 4677 E. MAIN STREET
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City | COLUMBUS
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State | OH
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Zip | 43213-3160
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Country | US
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Telephone | 614-575-6270
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Fax | 614-575-6282
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TRICIA L SMITH
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Credential |
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Telephone | 614-575-6270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34-004095-G
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License Number State | OH
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