Provider Demographics
NPI:1902821358
Name:RAY, TAMMY (MD)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:BUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 ABRAHAM FLEXNER WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2877
Practice Address - Country:US
Practice Address - Phone:502-852-5689
Practice Address - Fax:502-587-4840
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062292A207P00000X
KY41093207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01062292AOtherMED LICENSE
KYP00418586OtherRAILROAD MEDICARE
KY000000057678OtherANTHEM
KY2834249000OtherPASSPORT ADVANTAGE
KY50014456OtherPASSPORT
KY000000057678OtherANTHEM
IN01062292AOtherMED LICENSE
KY610893149001OtherTRICARE
KY2834249000OtherPASSPORT ADVANTAGE