Organization
P. TRUETT RAY, JR.,M.D.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. P. TRUETT RAY JR. MD (PHYSICIAN)
(985) 448-3055
Entity
Organization
Contact information
Practice address
504 N ACADIA RD, THIBODAUX, LA 70301-4862
(985) 447-5667
(985) 447-5670
Mailing address
504 N ACADIA RD, THIBODAUX, LA 70301-4862
(985) 447-5667
(985) 447-5670
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD013941
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1333948
—
LA
01
—
P0065497
RAILROAD MEDICARE
—
Enumeration date
10/06/2009
Last updated
10/06/2009
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