Provider Demographics
NPI:1679391379
Name:GRAY, PAUL EUGENE (MED)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EUGENE
Last Name:GRAY
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5217 MARYLAND WAY STE 307
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1056
Mailing Address - Country:US
Mailing Address - Phone:615-882-1792
Mailing Address - Fax:
Practice Address - Street 1:5217 MARYLAND WAY STE 307
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1056
Practice Address - Country:US
Practice Address - Phone:615-882-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health