Individual
GRAY B CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-2800
(505) 272-8692
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2002-0351
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28482034
—
NM
Enumeration date
08/01/2006
Last updated
04/26/2012
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