Provider Demographics
NPI:1700942117
Name:GRAYDEN, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:GRAYDEN
Suffix:
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 1:32531 N SCOTTSDALE RD STE 105-225
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-1519
Mailing Address - Country:US
Mailing Address - Phone:480-237-9776
Mailing Address - Fax:949-680-4147
Practice Address - Street 1:9741 N 90TH PL STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5065
Practice Address - Country:US
Practice Address - Phone:480-237-9776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2024-01-24
Deactivation Date:2023-12-20
Deactivation Code:
Reactivation Date:2024-01-24
Provider Licenses
StateLicense IDTaxonomies
CAG504012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry