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Organization

CENTER FOR ADVANCED LAPAROSCOPIC AND BARIATRIC SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES BRADLEY RAY MD (PRESIDENT)
(812) 330-9962
Entity
Organization

Contact information

Practice address
506 W 2ND ST, BLOOMINGTON, IN 47403-2316
(812) 961-0370
(812) 330-9962
Mailing address
506 W 2ND ST, BLOOMINGTON, IN 47403-2316
(812) 330-9962
(812) 330-9967

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
04046774A
IN

Other

Enumeration date
09/19/2007
Last updated
11/09/2015
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