Provider Demographics
NPI:1790027795
Name:GRAY, PAUL WESLEY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WESLEY
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 1:3206 WESTBURG CT SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3331
Mailing Address - Country:US
Mailing Address - Phone:256-882-2842
Mailing Address - Fax:
Practice Address - Street 1:3206 WESTBURG CT SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3331
Practice Address - Country:US
Practice Address - Phone:256-882-2842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.6955207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology