Provider Demographics
NPI:1932119989
Name:RAY, DAVID FRANCIS (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FRANCIS
Last Name:RAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:694 QUINLAN CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-9822
Mailing Address - Country:US
Mailing Address - Phone:219-663-2549
Mailing Address - Fax:219-322-0056
Practice Address - Street 1:966 W US HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1551
Practice Address - Country:US
Practice Address - Phone:219-322-8894
Practice Address - Fax:219-322-0056
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000703213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN480022814OtherMEDICARE RAILROAD
IN0241330001OtherMEDICARE DMERC
IL61100087OtherBLUE CROSS/BLUE SHIELD
IN000000088954OtherATHEM
IN100201670AMedicaid
IN0241330001OtherMEDICARE DMERC
IN100201670AMedicaid