Provider Demographics
NPI:1730179524
Name:GRAY, DAVID C (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:GRAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7300 E INDIANA ST STE 103
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7448
Mailing Address - Country:US
Mailing Address - Phone:812-401-8008
Mailing Address - Fax:270-886-0392
Practice Address - Street 1:7300 E INDIANA ST STE 103
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7448
Practice Address - Country:US
Practice Address - Phone:812-401-8008
Practice Address - Fax:270-886-0392
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY438832084P0800X
IN01042305A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100146340Medicaid
KYP400032325Medicare PIN
INF82636Medicare UPIN