Provider Demographics
NPI:1437295698
Name:GRAY, NORMAN ANTHONY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:ANTHONY
Last Name:GRAY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:11700 W 2ND PL
Mailing Address - Street 2:SUITE 350
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-1704
Mailing Address - Country:US
Mailing Address - Phone:303-595-2727
Mailing Address - Fax:303-629-2228
Practice Address - Street 1:11700 W 2ND PL
Practice Address - Street 2:SUITE 350
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1704
Practice Address - Country:US
Practice Address - Phone:303-595-2727
Practice Address - Fax:303-629-2228
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2015-02-11
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Provider Licenses
StateLicense IDTaxonomies
NY254100207R00000X
CO53631207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45275343Medicaid
CO369436YTNGMedicare PIN