Provider Demographics
NPI:1699863019
Name:TRAHAN, JAMES RAY (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RAY
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 505260
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5260
Mailing Address - Country:US
Mailing Address - Phone:816-436-7072
Mailing Address - Fax:816-436-2743
Practice Address - Street 1:211 NE 54TH ST STE 201
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4330
Practice Address - Country:US
Practice Address - Phone:816-453-6777
Practice Address - Fax:816-454-3601
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2018-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA270312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAEO3971Medicare UPIN