Individual
JEFFREY WAYNE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1450 BELLEMEADE AVE, EVANSVILLE, IN 47714-2062
(812) 477-0407
Mailing address
1450 BELLEMEADE AVE, EVANSVILLE, IN 47714-2062
(812) 477-0407
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20040332
IN
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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