Provider Demographics
NPI:1568630192
Name:RAY, AMY M (DO)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:RAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2422
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:225-381-2579
Practice Address - Street 1:8150 JEFFERSON HIGHWAY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-7715
Practice Address - Country:US
Practice Address - Phone:225-336-3100
Practice Address - Fax:225-381-2579
Is Sole Proprietor?:No
Enumeration Date:2008-02-17
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAPGY.1.BRGEN-FP207Q00000X
LAD0.000175207Q00000X
TXP0660207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1-00031-1Medicaid
LA1000311Medicaid
MS02135078Medicaid
TX8DK499OtherBCBS-TX
TX1568630192OtherTRICARE - SOUTH
TX1568630192OtherTRICARE - SOUTH
LA1-00031-1Medicaid