Provider Demographics
NPI:1164450755
Name:HILSMAN, GRAY (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAY
Middle Name:
Last Name:HILSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:853 WILSON DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4506
Mailing Address - Country:US
Mailing Address - Phone:601-991-3080
Mailing Address - Fax:601-991-0923
Practice Address - Street 1:853 WILSON DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4506
Practice Address - Country:US
Practice Address - Phone:601-991-3080
Practice Address - Fax:601-991-0923
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS070192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSB66037Medicare UPIN