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Individual

DR. CLARK ANTHONY GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22720 BUCKSVILLE RD, MCCALLA, AL 35111
(205) 481-8640
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-0777
(205) 481-7670
(205) 481-7573

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00024898
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009941477
AL
01
051539186
BLUE CROSS
AL
01
721608375
MEDICARE COMPLETE
AL
01
I32233
SENIORS FIRST
AL
Enumeration date
10/02/2006
Last updated
11/09/2012
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