Individual
PHILLIP GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
105 WILLOWBROOK WAY SE, CALHOUN, GA 30701-1404
(706) 625-6999
(706) 625-6990
Mailing address
PO BOX 12938, C/O CLINIC MANAGEMENT, CALHOUN, GA 30703
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
033340
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000461018E
—
GA
Enumeration date
01/27/2006
Last updated
12/17/2018
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