Individual
DR. SCOTT KEVIN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
8604 DOLLARWAY RD, WHITE HALL, AR 71602-2814
(870) 536-3669
(870) 536-0149
Mailing address
8604 DOLLARWAY RD, WHITE HALL, AR 71602-2814
(870) 536-3669
(870) 536-0149
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
1597
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
197
AR
213ES0103X
Foot & Ankle Surgery Podiatrist
218
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146570717
—
AR
01
—
5W846
BLUE CROSS & BLUE SHIELD
AR
Enumeration date
10/10/2005
Last updated
11/07/2012
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