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Individual

MR. CARL W GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
11401 INTERSTATE 30, LITTLE ROCK, AR 72209-7042
(501) 455-7100
(501) 455-7399
Mailing address
PO BOX 22390, HOT SPRINGS, AR 71903-2390
(800) 235-1415
(913) 234-1108

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00604
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59681
BCBS AR
01
P00195200
RR MEDICARE
Enumeration date
10/06/2005
Last updated
03/27/2008
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