Provider Demographics
NPI:1538187570
Name:GROOVER, RAY JR (MD)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:
Last Name:GROOVER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10288
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-0288
Mailing Address - Country:US
Mailing Address - Phone:205-502-5766
Mailing Address - Fax:205-502-3075
Practice Address - Street 1:2401 15TH AVE N
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35234-2833
Practice Address - Country:US
Practice Address - Phone:205-502-5766
Practice Address - Fax:205-502-3075
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL57362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1538187570Medicaid
AL510-05559OtherBC BS OF ALABAMA
AL510-05559OtherBC BS OF ALABAMA