Provider Demographics
NPI:1275522740
Name:RAY, CLINTON MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:CLINTON
Middle Name:MICHAEL
Last Name:RAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 HAMRIC DR E
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-2173
Mailing Address - Country:US
Mailing Address - Phone:256-241-4842
Mailing Address - Fax:256-241-4833
Practice Address - Street 1:1419 HAMRIC DR E
Practice Address - Street 2:SUITE 201
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-2173
Practice Address - Country:US
Practice Address - Phone:256-241-4842
Practice Address - Fax:256-241-4833
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.23812207X00000X
AL00023812207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051501324OtherBLUE SHIELD
AL622214001OtherMEDICARE PTAN DME
AL051501324Medicaid
H32802Medicare UPIN
AL051501324Medicare PIN