Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | DPM.200035 | LA |
NPI | 1013959030 |
---|---|
Provider Name | Dr. George Edward Ray |
First Address | New Orleans, LA 70125-4202 |
Second Address | New Orleans, LA 70125-4202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 05/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2104551 | (05) | LA |
4M981 | (02) | LA |