1932559630 NPI number — DR. NEIL EDWARD OKEY GREY MD

Table of content: DR. NEIL EDWARD OKEY GREY MD (NPI 1932559630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932559630 NPI number — DR. NEIL EDWARD OKEY GREY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GREY
Provider First Name:
NEIL
Provider Middle Name:
EDWARD OKEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OKEY
Provider Other First Name:
NEIL
Provider Other Middle Name:
EDWARD
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932559630
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2008 CARIBOU DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT COLLINS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80525-4325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-484-4757
Provider Business Mailing Address Fax Number:
970-484-4759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1024 S LEMAY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT COLLINS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80524-3929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-495-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  34188 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 14226A , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: DR.0067621 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)