Organization
RAY ANDREW, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY ALLEN ANDREW M.D. (OWNER)
(435) 259-4466
Entity
Organization
Contact information
Practice address
2700 S HIGHWAY 191 STE 2, MOAB, UT 84532-3443
(435) 259-4466
(435) 259-4467
Mailing address
2700 S HIGHWAY 191 STE 2, MOAB, UT 84532-3443
(435) 259-4466
(435) 259-4467
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
5160918-0144
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107012421102
SELECT HEALTH PROVIDER #
UT
01
—
5141202-1205
STATE LICENSE NUMBER
UT
01
—
51412021201001
BLUE CROSS BLUE SHIELD
UT
05
—
558752212-004
—
UT
01
—
68474
PEHP PROVIDER NUMBER
UT
01
—
755227
DMBA PROVIDER #
UT
01
—
QM0000071700
ALTIUS PROVIDER NUMBER
UT
Enumeration date
11/25/2006
Last updated
05/21/2025
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