Individual
DR. LESLIE B. GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
15657
MS
2086S0129X
Vascular Surgery Physician
Primary
15657
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119529
—
MS
01
—
009809700
MEDICAID OF AL
AL
01
—
020038463
RAILROAD MEDICARE
—
Enumeration date
08/19/2005
Last updated
05/12/2020
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