Doctor Name: | DR. BETTY MCGURK RAY |
NPI Number: | 1225270846 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 01025161A |
Business Practice Address: | 740 Mount Rainier Dr Indianapolis, IN - 462173939 |
Business Phone Number: | 3177844872 |
Business Fax Number: | |
Mailing Address: | 740 Mount Rainier Dr, INDIANAPOLIS |
State: | IN |
Postal Code: | 462173939 |
Phone Number: | 3179105409 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2009 |
NPI Last Update Date: | 12/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01025161A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |