Gray, Roger Sloan

Gray, Roger Sloan is an individual health care provider with primary practice located at 2820 S Wisconsin Ave , Rice Lake WI 54868-8573. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Gray, Roger Sloan can be contacted via phone (745) 234-8444.

Contact Information

Primary practice address
2820 S Wisconsin Ave Rice Lake WI 54868-8573
Phone: (745) 234-8444
Fax: (715) 234-0041
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 30897020 Wisconsin

Profile Details

NPI number 1154323608
LBN Legal business name Gray, Roger Sloan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Mar 22nd, 2022 - about 2 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 1154323608 NPPES
Wisconsin MEDICAID 31602400

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