Provider Demographics
NPI:1659467488
Name:GRAY, CARY F (MD)
Entity Type:Individual
Prefix:DR
First Name:CARY
Middle Name:F
Last Name:GRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1150 ROBERT BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2004
Mailing Address - Country:US
Mailing Address - Phone:985-646-4444
Mailing Address - Fax:985-646-4448
Practice Address - Street 1:1150 ROBERT BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2004
Practice Address - Country:US
Practice Address - Phone:985-646-4444
Practice Address - Fax:985-646-4448
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LALO13790208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00011676Medicaid
LA1303755Medicaid
MS00011676Medicaid
LA1303755Medicaid