Individual
KYLE JUSTIN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
11808 S MAY AVE, OKLAHOMA CITY, OK 73170-2560
(405) 735-2370
(405) 735-2369
Mailing address
PO BOX 721776, NORMAN, OK 73070-8360
(405) 600-6869
(405) 600-6978
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1873
OK
Other
Enumeration date
01/13/2010
Last updated
05/09/2014
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