Organization
GRAY & ALLEN PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS S GRAY MD (PRESIDENT)
(502) 456-4100
Entity
Organization
Contact information
Practice address
1169 EASTERN PKWY, 1111, LOUISVILLE, KY 40217-1417
(502) 456-4100
Mailing address
1169 EASTERN PKWY, 1111, LOUISVILLE, KY 40217-1417
(502) 456-4100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1052163
PASSPORT
KY
01
—
2433215001
PASSPORT ADVANTAGE GROUP
KY
05
—
65931321
—
KY
01
—
CI6232
RAILROAD MEDICARE GROUP
KY
Enumeration date
03/05/2007
Last updated
11/19/2007
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