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General NPI Number Information
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NPI Number | 1619922275
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Entity Type | Individual
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Provider Name | RAYBURN FRANCIS REGO MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 4301 W MARKHAM ST # 783
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 251-470-5842
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 W MARKHAM ST # 783
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 26082
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | E-5416
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License Number State | AR
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