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Contact Information

IRVING O GRAYSON JR
1555 N. MAIN ST.
FAYETTE, MS39069
 Phone: 601-786-8091
 Fax: 601-786-8023
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for IRVING O GRAYSON JR · (Male)

NPI Number 1568089274
Status Active
Credentials
Entity Individual
Enumeration date 06/29/2020
Last updated 05/14/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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