Doctor Name: | MR. RAY MORRIS JOE |
NPI Number: | 1134419518 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 500 North Mundo Road Dulce, NM - 87528 |
Business Phone Number: | 5757597309 |
Business Fax Number: | |
Mailing Address: | Po Box 187, DULCE |
State: | NM |
Postal Code: | 875280187 |
Phone Number: | 5757597309 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2011 |
NPI Last Update Date: | 04/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 246RM2200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Pathology |
Taxonomy Specialization: | Medical Laboratory |
Taxonomy Definition: |