Provider Demographics
NPI:1538141783
Name:WRAY, JOCELYN MARIE FOSTER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:MARIE FOSTER
Last Name:WRAY
Suffix:
Gender:F
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:140 FOX RD STE 106
Practice Address - Street 2:
Practice Address - City:VAN WERT
Practice Address - State:OH
Practice Address - Zip Code:45891-2490
Practice Address - Country:US
Practice Address - Phone:419-605-0850
Practice Address - Fax:419-238-8688
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35078836W208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3138465Medicaid
OH341941986OtherMEDICAL LICENSE
OH4039533Medicare PIN