Provider Demographics
NPI:1679569206
Name:RAY, ADRIAN K (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:K
Last Name:RAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-0172
Mailing Address - Country:US
Mailing Address - Phone:573-815-3573
Mailing Address - Fax:314-631-4491
Practice Address - Street 1:1600 E BROADWAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5844
Practice Address - Country:US
Practice Address - Phone:573-815-3573
Practice Address - Fax:314-631-4491
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2010-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2004027797207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine