Individual
DR. LESLIE C GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9900 MEDLOCK BRIDGE RD, DULUTH, GA 30097-2017
(770) 497-0699
(770) 497-0388
Mailing address
9900 MEDLOCK BRIDGE RD, DULUTH, GA 30097-2017
(770) 497-0699
(770) 497-0388
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
040083
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00757325E
—
GA
01
—
070014922
RAILROAD MEDICARE
GA
Enumeration date
06/02/2005
Last updated
06/13/2019
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