Individual
TIMOTHY J GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1303 W EVERGREEN AVE STE 200, EFFINGHAM, IL 62401-1638
(217) 342-3400
(217) 342-3477
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4653
(217) 868-2812
(217) 258-2216
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036082647
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036082647
—
IL
01
—
227129
HEALTHLINK
IL
Enumeration date
05/30/2006
Last updated
01/26/2022
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