# SPINE & SPORTS MEDICINE CENTER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295756112
- **Authorized official:** VICTOR GRAY M.D. (PHYSICIAN)
- **Authorized official phone:** (662) 842-4919

## Contact information

- **Practice address:** 218 S THOMAS ST, SUITE 110, TUPELO, MS 38801-5330
- **Practice address phone:** (662) 842-4919
- **Practice address fax:** (662) 842-9140
- **Mailing address:** PO BOX 2439, SUITE 110, TUPELO, MS 38803-2439
- **Mailing address phone:** (662) 842-4919
- **Mailing address fax:** (662) 842-9140

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 15561 | MS | Yes |

## Other

- **Enumeration date:** 07/23/2006
- **Last updated:** 02/18/2014