Provider Demographics
NPI:1801183439
Name:RAY, ANDREW J (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:RAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 CORNERSTONE WAY SE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-4791
Mailing Address - Country:US
Mailing Address - Phone:706-629-8622
Mailing Address - Fax:
Practice Address - Street 1:120 CORNERSTONE WAY SE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-4791
Practice Address - Country:US
Practice Address - Phone:706-629-8622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-04
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH17732208600000X
GA89182208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery