Grayson, Richard Jeffrey

Grayson, Richard Jeffrey is an sole proprietor health care provider with primary practice located at 40 Avon Meadow Ln , Avon CT 06001-3753. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Grayson, Richard Jeffrey can be contacted via phone (860) 677-7733.

Contact Information

Primary practice address
40 Avon Meadow Ln Avon CT 06001-3753
Phone: (860) 677-7733
Fax: (860) 677-7512
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 1437 Florida
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X P313 Connecticut
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X P313 Connecticut

Profile Details

NPI number 1184618480
LBN Legal business name Grayson, Richard Jeffrey
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 1st, 2005
Last updated Jun 27th, 2021 - about 4 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 1184618480 NPPES
Connecticut MEDICAID 004050050

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