Gray, Duriel Donnell
Gray, Duriel Donnell is an individual health care provider with primary practice located at 304 Shorter Ave Nw , Rome GA 30165-4290. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gray, Duriel Donnell can be contacted via phone (706) 291-3700.Contact Information
Primary practice address
304 Shorter Ave Nw
Rome GA 30165-4290
Phone: (706) 291-3700
Fax: (706) 291-8712
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 47474 | Tennessee |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 71075 | Georgia |
Profile Details
NPI number | 1619170701 |
---|---|
LBN Legal business name | Gray, Duriel Donnell |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 7th, 2007 |
Last updated | Feb 3rd, 2014 - about 10 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 | 1619170701 | NPPES |
Georgia | MEDICAID | 003141358A | |
Georgia | MEDICAID | 1523716 |
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