Provider Demographics
NPI:1346046695
Name:GRAY UROLOGY WELLNESS LLC
Entity type:Organization
Organization Name:GRAY UROLOGY WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-338-0960
Mailing Address - Street 1:1985 AL HIGHWAY 157 STE B
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-1124
Mailing Address - Country:US
Mailing Address - Phone:256-300-2595
Mailing Address - Fax:256-302-8055
Practice Address - Street 1:1985 AL HIGHWAY 157 STE B
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-1124
Practice Address - Country:US
Practice Address - Phone:256-300-2595
Practice Address - Fax:256-302-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty