Gray, Timothy J

Gray, Timothy J is an individual health care provider with primary practice located at 1303 W Evergreen Ave Ste 200 , Effingham IL 62401-1638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gray, Timothy J can be contacted via phone (217) 342-3400.

Contact Information

Primary practice address
1303 W Evergreen Ave Ste 200 Effingham IL 62401-1638
Phone: (217) 342-3400
Fax: (217) 342-3477
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036082647 Illinois

Profile Details

NPI number 1215984752
LBN Legal business name Gray, Timothy J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Jan 26th, 2022 - about 3 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 1215984752 NPPES
Illinois MEDICAID 036082647
Illinois Other 227129

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