Provider Demographics
NPI:1942220686
Name:GRAY, JAMES S (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:GRAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5425 N ORACLE RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-3890
Mailing Address - Country:US
Mailing Address - Phone:520-742-9166
Mailing Address - Fax:520-742-9146
Practice Address - Street 1:5425 N ORACLE RD
Practice Address - Street 2:SUITE 115
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-3890
Practice Address - Country:US
Practice Address - Phone:520-742-9166
Practice Address - Fax:520-742-9146
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ191542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ76302Medicaid
AZE38178Medicare UPIN
AZ76302Medicaid