Derrick Andre Gray M.D.

NPI 1609073022 - Family Medicine - 207Q00000X

NPI Details
NPI 1609073022
Gender Male
Enumeration Date 06/29/2007
Last Updated 10/26/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
601 W. MAPLE
SUITE 102
SPRINGDALE AR, 72764-5370, US
Phone (479) 750-6585
Fax (479) 757-2963
Business Location
601 W. MAPLE
SUITE 102
SPRINGDALE AR, 72764-5370, US
Phone (479) 750-6585
Fax (479) 757-2963
Toxanomy
Taxonomy Code 207Q00000X
License State Arkansas
License Number E6424
Remove 1609073022 NPI Number
 

According to our database, Dr. Derrick Andre Gray M.D. NPI is 1609073022, taxonomy code is 207Q00000X and license number is E6424, license state is located at Arkansas. Derrick Andre Gray M.D. physically located at 601 W. Maple, Springdale AR, 72764-5370. NPI Number Derrick Andre Gray M.D. has the Individual type.

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1609073022 NPI number is provided on an as is basis without warranty of any kind. 1609073022 is maintained by the National Plan & Provider Enumeration System. The contents of Derrick Andre Gray M.D. are for informational purposes only.