Individual
KATHERINE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647-1038
(208) 875-3988
(208) 587-3324
Mailing address
120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647-1038
(208) 587-3988
(208) 587-3324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-14835
ID
207Q00000X
Family Medicine Physician
TL0006271
CO
Other
Enumeration date
06/07/2016
Last updated
05/14/2024
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