Individual
GORDON MATTHEW GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2825 STOCKYARD RD, BLDG I-200, MISSOULA, MT 59808-1503
(406) 728-8420
Mailing address
PO BOX 17527, MISSOULA, MT 59808-7527
(406) 728-8420
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
7558
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0104520
—
MT
05
—
805002900
—
ID
Enumeration date
10/20/2005
Last updated
07/08/2014
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