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NPI Code Detail

MEDICARE: MS. DAWN GRAY BA

MEDICARE: MS. DAWN GRAY BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1063627222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DAWN GRAY BA
Provider Business Mailing Address
First Line : 700 SW PENN
Second Line :
City : BARTLESVILLE
State : OK
Zip : 74003-3847
Country : US
Telephone Number : 918-337-8080
Fax Number : 918-337-8099
Provider Business Practice Location Address
First Line : 700 SW PENN
Second Line :
City : BARTLESVILLE
State : OK
Zip : 74003-3847
Country : US
Telephone Number : 918-337-8080
Fax Number : 918-337-8099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 03/17/2020

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