Provider Demographics
NPI:1639598246
Name:GRAY, GERAD (DO)
Entity type:Individual
Prefix:
First Name:GERAD
Middle Name:
Last Name:GRAY
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:614-533-6497
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:2030 STRINGTOWN RD STE 300
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3993
Practice Address - Country:US
Practice Address - Phone:614-544-0101
Practice Address - Fax:614-544-0102
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1573207R00000X
OH34.017608208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100680860Medicaid
MS05272328Medicaid
FL105644500Medicaid
AL211102Medicaid