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General NPI Number Information
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NPI Number | 1649219130
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Entity Type | Individual
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Provider Name | THOMAS C RAYSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1506 S ONEIDA ST
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City | APPLETON
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State | WI
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Zip | 54915-1305
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Country | US
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Telephone | 920-739-2127
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E WASHINGTON ST P O BOX 8031
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City | APPLETON
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State | WI
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Zip | 54911-5490
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Country | US
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Telephone | 800-236-8252
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Fax | 920-739-0124
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology
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License Number | 34555-20
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License Number State | WI
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