Individual
DR. JONATHAN RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 KRESGE WAY, LOUISVILLE, KY 40207-4605
(502) 895-8911
(502) 895-8977
Mailing address
3950 KRESGE WAY STE 308, LOUISVILLE, KY 40207-4637
(502) 895-9627
(502) 895-8977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
38020
KY
208M00000X
Hospitalist Physician
Primary
38020
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000306523
ANTHEM BLUE CROSS
KY
01
—
50001321
PASSPORT
KY
05
—
64070618
—
KY
01
—
P00039174
RAILROAD MEDICARE
KY
01
—
P00420128
RAILROAD MEDICARE KY
KY
Enumeration date
03/17/2006
Last updated
12/17/2014
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