Provider Demographics
NPI:1730199480
Name:GRAY, THEODORE FLINT III (MD)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:FLINT
Last Name:GRAY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 3710
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-3710
Mailing Address - Country:US
Mailing Address - Phone:828-324-9550
Mailing Address - Fax:828-624-4154
Practice Address - Street 1:2406 CENTURY PL SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602
Practice Address - Country:US
Practice Address - Phone:828-324-9550
Practice Address - Fax:828-624-4154
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2024-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC38346207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE50921Medicare UPIN