Provider Demographics
NPI:1801881438
Name:GRAY, JEAN PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:PAUL
Last Name:GRAY
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 1:244 COATSLAND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3948
Mailing Address - Country:US
Mailing Address - Phone:731-422-4642
Mailing Address - Fax:731-422-2277
Practice Address - Street 1:244 COATSLAND DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3948
Practice Address - Country:US
Practice Address - Phone:731-422-4642
Practice Address - Fax:731-422-2277
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20854207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3055427Medicaid
TN4536814OtherAETNA
TN3031059OtherBLUE CROSS BLUE SHIELD
TN8959894OtherCIGNA
TN744559Other1ST HEALTH
TN4536814OtherAETNA
TN3031059OtherBLUE CROSS BLUE SHIELD