Gray, Russell Lamar
Gray, Russell Lamar is an individual health care provider with primary practice located at 795 W Overland Rd , Meridian ID 83642-6556. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Gray, Russell Lamar can be contacted via phone (208) 917-6907.Contact Information
Primary practice address
795 W Overland Rd
Meridian ID 83642-6556
Phone: (208) 917-6907
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-100476 | Idaho |
Profile Details
| NPI number | 1023678778 |
|---|---|
| LBN Legal business name | Gray, Russell Lamar |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2019 |
| Last updated | Jan 18th, 2024 - about last year |
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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