Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 30601 | OK |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 30601 | OK |
NPI | 1558552737 |
---|---|
Provider Name | Dr. Sylvia Susana Gray |
First Address | Edmond, OK 73013-8561 |
Second Address | Edmond, OK 73013-8561 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 06/02/2020 |