MEDICARE: DR. HOLLIDAY KANE RAYFIELD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	0420009726	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366467177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOLLIDAY KANE RAYFIELD M.D.

Provider Business Mailing Address
First Line	:	55 MAIN ST
Second Line	:	STE 1
City	:	ESSEX JUNCTION
State	:	VT
Zip	:	05452-6100
Country	:	US
Telephone Number	:	802-288-1087
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 MAIN ST
Second Line	:	STE 1
City	:	ESSEX JUNCTION
State	:	VT
Zip	:	05452-6100
Country	:	US
Telephone Number	:	802-288-1087
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	01/30/2019

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