| Dr Alan James Gray, MD | |
| 
					2593 N Bird St, Boise, ID 83704-5649  | |
| (208) 631-6990 | |
| Not Available | 
| Full Name | Dr Alan James Gray | 
|---|---|
| Gender | Male | 
| Speciality | Otolaryngology - Facial Plastic Surgery | 
| Location | 2593 N Bird St, Boise, Idaho | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1831651447 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | 73221 (Arizona) | Primary | 
| Entity Name | Gray Facial Plastic Surgery | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1104638451 PECOS PAC ID: 4981126315 Enrollment ID: O20250314002315  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Alan James Gray, MD 2593 N Bird St, Boise, ID 83704-5649 Ph: (208) 631-6990  | Dr Alan James Gray, MD 2593 N Bird St, Boise, ID 83704-5649 Ph: (208) 631-6990  | 
Seung Yong Ji, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-336-4368  | |
Mrs. Tiffany Kearny, PA Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-367-7423  | |
Dr. Eric T Garner, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St, Ste 400, Boise, ID 83704 Phone: 208-367-3320 Fax: 208-367-7474  | |
Dr. Jacob G Robison, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 100 E Idaho St, Boise, ID 83712 Phone: 208-381-9590  | |
Dr. Todd Rustad, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 900 N Liberty St, Ste 400, Boise, ID 83704 Phone: 208-367-3320 Fax: 208-367-7474  | |
Tyson Nielsen, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-367-3320 Fax: 208-267-3979  | |
David Michael Lewis, DO Otolaryngology Medicare: Medicare Enrolled Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-367-3320  |