Gray, Leslie C
Gray, Leslie C is an individual health care provider with primary practice located at 9900 Medlock Bridge Rd , Duluth GA 30097-2017. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Gray, Leslie C can be contacted via phone (770) 497-0699.Contact Information
Primary practice address
9900 Medlock Bridge Rd
Duluth GA 30097-2017
Phone: (770) 497-0699
Fax: (770) 497-0388
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 040083 | Georgia |
Profile Details
| NPI number | 1720082084 |
|---|---|
| LBN Legal business name | Gray, Leslie C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2005 |
| Last updated | Jun 13th, 2019 - about 5 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 | 1720082084 | NPPES |
| Georgia | MEDICAID | 00757325E | |
| Georgia | Other | 070014922 |
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