Organization
JAMES BRADLEY RAY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BRADLEY RAY MD (OWNER)
(812) 330-9962
Entity
Organization
Contact information
Practice address
822 W 1ST ST, SUITE 7, BLOOMINGTON, IN 47403-2384
(812) 330-9962
(812) 330-9967
Mailing address
502 W 2ND ST, BLOOMINGTON, IN 47403-2316
(812) 330-9962
(812) 330-9967
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01046774
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200195160
—
IN
Enumeration date
09/28/2006
Last updated
07/08/2008
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