Provider Demographics
NPI:1093772238
Name:WRAY, GEORGE W III (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:W
Last Name:WRAY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 W PACES FERRY RD NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2308
Mailing Address - Country:US
Mailing Address - Phone:404-525-7409
Mailing Address - Fax:404-522-0608
Practice Address - Street 1:1218 W PACES FERRY RD NW
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2308
Practice Address - Country:US
Practice Address - Phone:404-525-7409
Practice Address - Fax:404-522-0608
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046285174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH39687Medicare UPIN