Provider Demographics
NPI:1437508967
Name:SUMNER, GRAYSON (DO)
Entity type:Individual
Prefix:
First Name:GRAYSON
Middle Name:
Last Name:SUMNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HIGHWAY 246 N
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-8748
Mailing Address - Country:US
Mailing Address - Phone:864-725-1750
Mailing Address - Fax:864-725-1762
Practice Address - Street 1:110 HIGHWAY 246 N
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-8748
Practice Address - Country:US
Practice Address - Phone:864-725-1750
Practice Address - Fax:864-725-1762
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC39238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine