Individual
DR. WILLIAM GRADY SELF JR.
Active
Individual
DR. WILLIAM GRADY SELF JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20828
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01208289
—
CO
01
—
0800375
EVERCARE
—
01
—
180032795
RAILROAD MEDICARE
—
01
—
222002
UNITED HEALTHCARE
—
01
—
4098038
AETNA PPO
—
01
—
814630
AETNA HMO
—
01
—
840787518002
ROCKY MTN HEALTH PLAN
—
01
—
840787518A002
TRICARE
—
01
—
920665
EYE SPECIALISTS
—
01
—
SE87324
BLUE CROSS/BLUE SHIELD
—
Enumeration date
06/28/2005
Last updated
04/23/2008
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