Provider Demographics
NPI:1336186733
Name:RAY SCAN INC.
Entity Type:Organization
Organization Name:RAY SCAN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-723-2132
Mailing Address - Street 1:401 S ALABAMA ST
Mailing Address - Street 2:SUITE 6B
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2315
Mailing Address - Country:US
Mailing Address - Phone:406-723-2132
Mailing Address - Fax:406-723-6144
Practice Address - Street 1:401 S ALABAMA ST
Practice Address - Street 2:SUITE 6B
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2315
Practice Address - Country:US
Practice Address - Phone:406-723-2132
Practice Address - Fax:406-723-6144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT80112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8011OtherLICENSE
MT84622Medicare ID - Type UnspecifiedMEDICARE GROUP ID#
MT8011OtherLICENSE