Provider Demographics
NPI:1427164201
Name:GRAY, TONYA L (MD)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:L
Last Name:GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:621 S ILLINOIS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-5489
Mailing Address - Country:US
Mailing Address - Phone:641-494-3041
Mailing Address - Fax:641-494-3059
Practice Address - Street 1:1010 4TH ST SW
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2857
Practice Address - Country:US
Practice Address - Phone:641-422-6020
Practice Address - Fax:641-422-7803
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA35644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA37238OtherWELLMARK
IA0447698Medicaid
IA37238OtherWELLMARK
IA0447698Medicaid