Individual
DR. RUSSELL AUSTIN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
(707) 423-3000
Mailing address
101 BODIN CIR, FAIRFIELD, CA 94535-1809
(707) 423-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
46904
AZ
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
46904
AZ
Other
Enumeration date
05/16/2011
Last updated
09/08/2022
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