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Individual

TIMOTHY G GRAYSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 228-5500
Mailing address
900 CAIRO RD, THOMASVILLE, GA 31792-4255

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
048050
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000841365A
GA
05
000841365B
GA
01
340017372
RR MEDICARE
GA
Enumeration date
12/06/2005
Last updated
08/03/2020
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