Individual
ROBERT BOURDEAUX GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 ESTILL ST, BEREA, KY 40403-1742
(859) 986-3151
Mailing address
4390 CLEARWATER WAY, APT 1110, LEXINGTON, KY 40515-6359
(859) 971-2279
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35942
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64018179
—
KY
Enumeration date
05/24/2006
Last updated
09/24/2007
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