Organization
NEW RIVER FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ALLEN RAY MD (PRESIDENT)
(336) 372-4644
Entity
Organization
Contact information
Practice address
12 WILLIS ST, SUITE C, SPARTA, NC 28675-9220
(336) 372-4644
(336) 372-7453
Mailing address
12 WILLIS ST, SUITE C, SPARTA, NC 28675-9220
(336) 372-4644
(336) 372-7453
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9501387
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0297Q
BCBS
NC
01
—
16069
PARTNERS
—
01
—
40023
MEDCOST
NC
05
—
890297Q
—
NC
Enumeration date
04/26/2007
Last updated
05/06/2008
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