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General NPI Number Information
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NPI Number | 1316178346
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Entity Type | Organization
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Legal Business Name | M.R. TAYLOR RAYBURN, JR. M.D. P.C.
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Dates
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Enumeration Date | 08/08/2009
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Last Update Date | 08/08/2009
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Provider Practice Location Address
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Address Line | 1411 HATCHER LN
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City | COLUMBIA
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State | TN
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Zip | 38401-3535
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Country | US
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Telephone | 931-381-1425
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Fax |
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Provider Business Mailing Address
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Address Line | 1411 HATCHER LN
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City | COLUMBIA
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State | TN
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Zip | 38401-3535
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Country | US
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Telephone | 931-381-1425
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAYLOR RAYBURN JR.
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Credential |
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Telephone | 931-381-1425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD3322
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License Number State | TN
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