Individual
DR. RUSSELL WAYNE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5001 HARDY ST, HATTIESBURG, MS 39402-1308
(601) 319-5647
Mailing address
12 E CROCKETT DR, SUMRALL, MS 39482-5062
(601) 319-5647
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
901751
MS
Other
Enumeration date
12/30/2021
Last updated
08/07/2023
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