Individual
MR. GORDON BRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
200 N RIVER ST, CLAXTON, GA 30417-1659
(912) 739-5297
(912) 739-5101
Mailing address
200 N RIVER ST, CLAXTON, GA 30417-1659
(912) 739-5297
(912) 739-5101
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN030371
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00908927A
—
GA
Enumeration date
01/29/2007
Last updated
07/09/2007
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