MEDICARE: RAY LESTER JAMES JR. MD

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	207RG0100X	Gastroenterology Physician	93691	SC
2	207RG0100X	Gastroenterology Physician	0101039107	VA
3	207RG0100X	Gastroenterology Physician	63830	TN

General Provider Information

NPI Number	:	1265436521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAY LESTER JAMES JR. MD

Provider Business Mailing Address
First Line	:	ONE GI CREDENTIALING DEPARTMENT
Second Line	:	PO BOX 381468
City	:	GERMANTOWN
State	:	TN
Zip	:	38183-1318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115B DOW ST
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37130-2487
Country	:	US
Telephone Number	:	615-896-6996
Fax Number	:

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	02/28/2025

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