Individual
MR. CHARLES RICHARD GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3207 N ACADEMY BLVD STE 3500, COLORADO SPRINGS, CO 80917-5100
(719) 632-5700
Mailing address
4790 FARTHING DRIVE, COLORADO SPRINGS, CO 80906
(719) 963-7579
(719) 538-2961
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2003002307
MO
363AM0700X
Medical Physician Assistant
Primary
PA.0002579
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
173190
BLUE CROSS BLUE SHIELD
MO
01
—
523191
HEALTHLINK
MO
Enumeration date
07/07/2006
Last updated
07/12/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us