Organization
RADFORD ORTHOPEDIC CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH W GRAY MD (PRESIDENT)
(540) 639-9315
Entity
Organization
Contact information
Practice address
601 HARVEY ST, RADFORD, VA 24141-2339
(540) 639-9315
(540) 731-0860
Mailing address
601 HARVEY ST, RADFORD, VA 24141-2339
(540) 639-9315
(540) 731-0860
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101036314
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006400205
—
VA
05
—
006430121
—
VA
01
—
0781510001
DMERC REGION C
VA
01
—
1033147376
NPI
—
01
—
1124056346
NPI
—
Enumeration date
11/08/2006
Last updated
08/21/2008
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