Provider Demographics
NPI:1205962065
Name:RAY WEBSTER, JOANN (MD)
Entity type:Individual
Prefix:DR
First Name:JOANN
Middle Name:
Last Name:RAY WEBSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:944A KINGS BAY ROAD
Mailing Address - Street 2:#121
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558
Mailing Address - Country:US
Mailing Address - Phone:912-576-1015
Mailing Address - Fax:904-321-2685
Practice Address - Street 1:214 PROFESSIONAL CIR
Practice Address - Street 2:UNIT A
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3733
Practice Address - Country:US
Practice Address - Phone:912-576-1015
Practice Address - Fax:904-321-2685
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA47512207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00838802AMedicaid
HO6384Medicare UPIN
18BDFQFMedicare ID - Type Unspecified