Provider Demographics
NPI:1477526366
Name:GRAY, AUSTON HAWKINS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:AUSTON
Middle Name:HAWKINS
Last Name:GRAY
Suffix:JR
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 1:315 HAYNSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4005
Mailing Address - Country:US
Mailing Address - Phone:803-236-3199
Mailing Address - Fax:
Practice Address - Street 1:315 HAYNSWORTH ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4005
Practice Address - Country:US
Practice Address - Phone:803-905-5650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC197942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC236177Medicaid
SCG95611Medicare UPIN