Gray, David R
Gray, David R is an individual health care provider with primary practice located at 1250 S Creasy Ln Suite A, Lafayette IN 47905-4960. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gray, David R can be contacted via phone (765) 449-2732.Contact Information
Primary practice address
1250 S Creasy Ln Suite A
Lafayette IN 47905-4960
Phone: (765) 449-2732
Fax: (765) 449-1196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 01041342A | Indiana |
Profile Details
| NPI number | 1457320210 |
|---|---|
| LBN Legal business name | Gray, David R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 15th, 2006 |
| Last updated | Apr 2nd, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457320210 | NPPES |
| Indiana | Other | 000000110554 | ANTHEM PROVIDER |
| Indiana | MEDICAID | 200165100 | ANTHEM PROVIDER |
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