Organization
ANDREA V GRAY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA V GRAY MD (PRESIDENT)
(541) 957-5400
Entity
Organization
Contact information
Practice address
2569 NW EDENBOWER BLVD, ROSEBURG, OR 97470
(541) 957-5400
(541) 440-1010
Mailing address
2569 NW EDENBOWER BLVD, ROSEBURG, OR 97470
(541) 957-5400
(541) 440-1010
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4373040001
DMERC
OR
Enumeration date
11/15/2007
Last updated
11/15/2007
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