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NPI Code Detail

MEDICARE: DR. GRAY W. FRIEDRICHS O.D.

MEDICARE:  DR. GRAY W. FRIEDRICHS  O.D.
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
1152W00000XOptometrist0618000917VA

General Provider Information

NPI Number : 1174526008
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GRAY W. FRIEDRICHS O.D.
Provider Business Mailing Address
First Line : 1975 VIRGINIA AVE
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24112-8388
Country : US
Telephone Number : 276-647-3937
Fax Number : 276-647-3990
Provider Business Practice Location Address
First Line : 1975 VIRGINIA AVE
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24112-8388
Country : US
Telephone Number : 276-647-3937
Fax Number : 276-647-3990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 03/30/2023

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Directions to “ DR. GRAY W. FRIEDRICHS O.D.” Practice Location

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