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General NPI Number Information
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NPI Number | 1720079940
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Entity Type | Individual
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Provider Name | SETH D RAYBURN MD
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Gender | Male
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 707 W MARKET ST STE C
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City | ATHENS
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State | AL
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Zip | 35611-2463
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Country | US
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Telephone | 256-216-6500
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Fax | 256-216-8777
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Provider Business Mailing Address
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Address Line | PO BOX 630
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City | ATHENS
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State | AL
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Zip | 35612-0630
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Country | US
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Telephone | 256-216-6500
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Fax | 256-216-8777
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 23684
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License Number State | AL
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