Individual
DR. PHILLIP HAROLD GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
105 S FULTON ST, IUKA, MS 38852-2328
(662) 423-3785
(662) 423-2849
Mailing address
105 S FULTON ST, IUKA, MS 38852-2328
(662) 423-3785
(662) 423-2849
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
469
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087882
—
MS
Enumeration date
04/12/2006
Last updated
03/12/2010
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