Provider Demographics
NPI:1073677316
Name:GRAY-DAVIS, YOLANDA NATASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:NATASHA
Last Name:GRAY-DAVIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4975 AARON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-7422
Mailing Address - Country:US
Mailing Address - Phone:706-682-2895
Mailing Address - Fax:
Practice Address - Street 1:4950 MARTIN LOOP
Practice Address - Street 2:
Practice Address - City:FT. BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:706-544-1556
Practice Address - Fax:706-544-4040
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine