Individual
TAMMY RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-2877
(502) 852-5689
(502) 587-4840
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01062292A
IN
207P00000X
Emergency Medicine Physician
Primary
41093
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057678
ANTHEM
KY
01
—
01062292A
MED LICENSE
IN
01
—
2834249000
PASSPORT ADVANTAGE
KY
01
—
50014456
PASSPORT
KY
01
—
P00418586
RAILROAD MEDICARE
KY
Enumeration date
07/13/2006
Last updated
12/04/2020
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