Individual
THOMAS M GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 REID PKWY, SUITE 120, RICHMOND, IN 47374-1155
(765) 962-6053
(765) 935-7401
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 983-3293
(765) 983-3219
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01048195
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000707433
ANTHEM
—
05
—
200180430
—
IN
05
—
2105117
—
OH
Enumeration date
06/14/2005
Last updated
05/14/2021
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