Healthcare Provider Details

I. General information

NPI: 1063966125
Provider Name (Legal Business Name): DR C RAY MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2016
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4848 E CACTUS RD
SCOTTSDALE AZ
85254-4163
US

IV. Provider business mailing address

4848 E CACTUS RD
SCOTTSDALE AZ
85254-4163
US

V. Phone/Fax

Practice location:
  • Phone: 623-293-3985
  • Fax: 602-343-7973
Mailing address:
  • Phone: 623-293-3985
  • Fax: 602-343-7973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number32707
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPER S RAY
Title or Position: OWNER
Credential: M.D.
Phone: 623-293-3985