Provider Demographics
NPI:1942264569
Name:GRECO, RAY S II (DO)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:S
Last Name:GRECO
Suffix:II
Gender:M
Credentials:DO
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Mailing Address - Street 1:4143 HOSPITAL DR NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2565
Mailing Address - Country:US
Mailing Address - Phone:770-787-2674
Mailing Address - Fax:770-787-6222
Practice Address - Street 1:4143 HOSPITAL DR NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2565
Practice Address - Country:US
Practice Address - Phone:770-787-2674
Practice Address - Fax:770-787-6222
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA25756207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000280266AMedicaid
GAD45474Medicare UPIN