Provider Demographics
NPI:1194219279
Name:RAY, COLIN (MD)
Entity Type:Individual
Prefix:
First Name:COLIN
Middle Name:
Last Name:RAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-7520
Mailing Address - Fax:317-806-1112
Practice Address - Street 1:9669 E 146TH ST STE 250
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-5006
Practice Address - Country:US
Practice Address - Phone:317-621-9926
Practice Address - Fax:317-621-9676
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN11020211A207Q00000X
IN01082548A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine