IndividualActive
Adam Wray, DO
NPI 1902952930 · Dermatology Physician · Blackfoot, ID
Provider details
- NPI number
- 1902952930
- Entity type
- Individual
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- O-0444 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1355 Parkway Dr Ste a
Blackfoot, ID 83221-1656
Phone: (986) 275-0003
Fax: (986) 275-0005
Approximate (ZIP-level) locationGet directions
Mailing address
1355 Parkway Dr Ste a
Blackfoot, ID 83221-1656
Additional practice locations (1)
- 500 S 11th Ave Ste 301Pocatello, ID 83201-4879Phone: (986) 275-0003
Registry dates
- Enumerated
- 2007-01-25
- Last updated
- 2026-05-06
- Certified
- 2026-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.