Basic Information
| Provider Information | |||||||||
| NPI: | 1386836864 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DRS RAY PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 983 | ||||||||
| Address2: | |||||||||
| City: | ELK CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 736480983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802255403 | ||||||||
| FaxNumber: | 5802255423 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 17TH ST | ||||||||
| Address2: | |||||||||
| City: | WOODWARD | ||||||||
| State: | OK | ||||||||
| PostalCode: | 738012448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802568188 | ||||||||
| FaxNumber: | 5802255423 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2007 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | RAY | ||||||||
| AuthorizedOfficialFirstName: | JASON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5803348068 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.