Provider Demographics
NPI:1750484218
Name:RAY, ROBIN P (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:P
Last Name:RAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:403 W OAK
Mailing Address - Street 2:SUITE 301
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730
Mailing Address - Country:US
Mailing Address - Phone:870-862-8221
Mailing Address - Fax:870-863-5682
Practice Address - Street 1:403 W OAK
Practice Address - Street 2:SUITE 301
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730
Practice Address - Country:US
Practice Address - Phone:870-862-8221
Practice Address - Fax:870-863-5682
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR36072080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR110868001Medicaid
AR110868001Medicaid