Doctor Name: | DR. ALAN B WRAY |
NPI Number: | 1013987452 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | M5030 |
Business Practice Address: | 3100 Channing Way Idaho Falls, ID - 834047533 |
Business Phone Number: | 2082272600 |
Business Fax Number: | |
Mailing Address: | Po Box 2671, IDAHO FALLS |
State: | ID |
Postal Code: | 834032671 |
Phone Number: | 2085234906 |
Fax Number: | 2085232025 |
NPI Enumeration Date: | 01/26/2006 |
NPI Last Update Date: | 08/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0204X |
License Number: | M5030 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ID |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Vascular & Interventional Radiology |
Taxonomy Definition: | A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |