Gray, Gary G

Gray, Gary G is an sole proprietor health care provider with primary practice located at 2490 N Water St Suite 16, Decatur IL 62526-4251. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics. Eye and Vision Services Providers / Corneal and Contact Management is his primary health care specialty. Gray, Gary G can be contacted via phone (217) 875-4646.

Contact Information

Primary practice address
2490 N Water St Suite 16 Decatur IL 62526-4251
Fax: (217) 875-2870
Website:

Health care specialties

Profile Details

NPI number 1275603672
LBN Legal business name Gray, Gary G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2006
Last updated Nov 20th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275603672 NPPES
Tennessee Other 4056086 BCBCS
Tennessee Other 5884008 BCBCS
Tennessee Other 6259G BCBCS
Tennessee Other 0159620001 BCBCS

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