Keith Gray OD

NPI 1063465391 - Optometrist - 152W00000X

NPI Details
NPI 1063465391
Gender Male
Enumeration Date 05/18/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1299 SOUTHLAND MALL
MEMPHIS TN, 38116-7807, US
Phone (901) 396-3742
Fax (901) 396-9744
Business Location
1299 SOUTHLAND MALL
MEMPHIS TN, 38116-7807, US
Phone (901) 396-3742
Fax (901) 396-9744
Toxanomy
Taxonomy Code 152W00000X
License State Tennessee
License Number 1153DT
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According to our database, Keith Gray OD NPI is 1063465391, taxonomy code is 152W00000X and license number is 1153DT, license state is located at Tennessee. Keith Gray OD physically located at 1299 Southland Mall, Memphis TN, 38116-7807. NPI Number Keith Gray OD has the Individual type.

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1063465391 NPI number is provided on an as is basis without warranty of any kind. 1063465391 is maintained by the National Plan & Provider Enumeration System. The contents of Keith Gray OD are for informational purposes only.