Provider Demographics
NPI:1205464039
Name:RAY, SCOTT LOGAN (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:LOGAN
Last Name:RAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:550 S JACKSON ST FL STREET3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 W MICHIGAN ST # FH204
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5209
Practice Address - Country:US
Practice Address - Phone:317-274-0076
Practice Address - Fax:317-274-0256
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC320104207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology