Gray, Gordon Matthew
Gray, Gordon Matthew is an individual health care provider with primary practice located at 2825 Stockyard Rd Bldg I-200, Missoula MT 59808-1503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Gray, Gordon Matthew can be contacted via phone (406) 728-8420.Contact Information
Primary practice address
2825 Stockyard Rd Bldg I-200
Missoula MT 59808-1503
Phone: (406) 728-8420
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 7558 | Montana |
Profile Details
| NPI number | 1568451680 |
|---|---|
| LBN Legal business name | Gray, Gordon Matthew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2005 |
| Last updated | Jul 8th, 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 | 1568451680 | NPPES |
| Idaho | MEDICAID | 805002900 | |
| Idaho | MEDICAID | 0104520 |
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