Healthcare Provider Details

I. General information

NPI: 1730520842
Provider Name (Legal Business Name): DAVID MITCHELL RAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 THE VANDERBILT CLINIC
NASHVILLE TN
37232-0001
US

IV. Provider business mailing address

719 THOMPSON LN STE 30330
NASHVILLE TN
37204-4701
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-3000
  • Fax:
Mailing address:
  • Phone: 615-322-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number58965
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number58965
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: