Provider Demographics
NPI:1801071725
Name:GRAY, PHILLIP JOHN JR (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:JOHN
Last Name:GRAY
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:48 MONTVALE AVE
Mailing Address - Street 2:
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-2425
Mailing Address - Country:US
Mailing Address - Phone:781-279-0655
Mailing Address - Fax:781-279-0409
Practice Address - Street 1:48 MONTVALE AVE
Practice Address - Street 2:
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-2425
Practice Address - Country:US
Practice Address - Phone:781-279-0655
Practice Address - Fax:781-279-0409
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2016-06-15
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Provider Licenses
StateLicense IDTaxonomies
MA2497282085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology