Individual
DR. GEORGE THOMPSON GRAY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1400 BRADEN ST, EMERGENCY DEPT, JACKSONVILLE, AR 72076-3721
(501) 985-7000
Mailing address
PO BOX 3925, SHREVEPORT, LA 71133-3925
(800) 684-0052
(405) 844-1794
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R-3735
AR
207Q00000X
Family Medicine Physician
Primary
R3735
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113616003
—
AR
01
—
P01027353
RAILROAD MCARE
—
Enumeration date
04/14/2006
Last updated
06/19/2012
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