Individual
DR. LANCE RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1607 PLANTATION ROAD, MOHAVE VALLEY, AZ 86440
(928) 346-4679
(928) 346-4686
Mailing address
1607 PLANTATION ROAD, MOHAVE VALLEY, AZ 86440
(928) 346-4679
(928) 346-4686
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
12094
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669540316
BC/BS
AZ
05
—
306467
—
AZ
Enumeration date
02/22/2007
Last updated
09/05/2008
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