Individual
DR. DENNIS S GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1169 EASTERN PKWY, STE 1111, LOUISVILLE, KY 40217-1462
(502) 456-4100
(502) 459-8454
Mailing address
1169 EASTERN PKWY, STE 1111, LOUISVILLE, KY 40217-1462
(502) 456-4100
(502) 459-8454
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21462
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000600891
BC BS
—
01
—
080135036
RR MEDICARE
KY
01
—
3633466000
PASSPORT ADVANTAGE
KY
01
—
4380607
AETNA
KY
01
—
50021730
PASSPORT
KY
05
—
64214620
—
KY
01
—
6896823
CIGNA
KY
Enumeration date
06/01/2005
Last updated
06/10/2020
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