MEDICARE: DR. DAVID G. RAY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	2003-0684	NM
2	208VP0014X	Interventional Pain Medicine Physician	59135	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053314526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID G. RAY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6408
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85261-6408
Country	:	US
Telephone Number	:	480-563-6400
Fax Number	:	480-563-8009

Provider Business Practice Location Address
First Line	:	655 S DOBSON RD STE 205
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85224-5669
Country	:	US
Telephone Number	:	480-563-6400
Fax Number	:	480-563-8009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	10/26/2020

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