Provider Demographics
NPI:1417056185
Name:GRAY FAMILY CLINIC PLC
Entity Type:Organization
Organization Name:GRAY FAMILY CLINIC PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:JOLENA
Authorized Official - Last Name:COTE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:423-467-8001
Mailing Address - Street 1:132 OLD GRAY STATION ROAD
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-3434
Mailing Address - Country:US
Mailing Address - Phone:423-467-8001
Mailing Address - Fax:423-467-8003
Practice Address - Street 1:132 OLD GRAY STATION ROAD
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:TN
Practice Address - Zip Code:37615-3434
Practice Address - Country:US
Practice Address - Phone:423-467-8001
Practice Address - Fax:423-467-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty