Provider Demographics
NPI:1912982422
Name:GAY, ANTHONY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:SCOTT
Last Name:GAY
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 1:1750 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031
Mailing Address - Country:US
Mailing Address - Phone:541-386-5070
Mailing Address - Fax:541-386-7190
Practice Address - Street 1:1750 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031
Practice Address - Country:US
Practice Address - Phone:541-386-5070
Practice Address - Fax:541-386-7190
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
11004OtherBLUE CROSS BLUE SHIELD
OR024211Medicaid
K5099 03OtherPACIFIC SOURCE
WA8126997Medicaid
080028718OtherRAILROAD MEDICARE
1256728OtherUNITED HEALTHCARE
WA55852OtherDEPT OF LABOR AND INDUSTR
K5099 03OtherPACIFIC SOURCE
080028718OtherRAILROAD MEDICARE