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General NPI Number Information
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NPI Number | 1487958781
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Entity Type | Organization
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Legal Business Name | DERRELL W. RAY M.D. P.C.
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Dates
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Enumeration Date | 12/29/2010
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Last Update Date | 12/29/2010
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Provider Practice Location Address
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Address Line | 340 EISENHOWER DR
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City | SAVANNAH
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State | GA
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Zip | 31406-1600
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Country | US
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Telephone | 912-354-4400
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Fax | 912-354-4040
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Provider Business Mailing Address
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Address Line | 8920 EVES RD P.O. BOX 769179
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City | ROSWELL
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State | GA
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Zip | 30076-9998
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Country | US
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Telephone | 912-354-4400
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Fax | 912-354-4040
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Authorized Official
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Title or Position | OWNER
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Name | DERRELL W RAY
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Credential | M.D.
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Telephone | 912-354-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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