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Individual

MR. NATHAN CHARLES GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MMS, PA-C

Contact information

Practice address
262 DANNY THOMAS PLACE, MS #800, MEMPHIS, TN 38105
(901) 595-2813
(901) 595-2952
Mailing address
262 DANNY THOMAS PLACE, MS #800, MEMPHIS, TN 38105
(901) 595-2813
(901) 595-2952

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03599
NC
363A00000X
Physician Assistant
Primary
2327
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8102662
NC
Enumeration date
06/20/2012
Last updated
05/17/2013
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