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NPI Code Detail

MEDICARE: RAILEY HERREN

MEDICARE:   RAILEY  HERREN
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1386448488
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAILEY HERREN
Provider Business Mailing Address
First Line : 17410 GLAZE RD
Second Line :
City : ATHENS
State : AL
Zip : 35611-7573
Country : US
Telephone Number : 256-321-0063
Fax Number :
Provider Business Practice Location Address
First Line : 630 E RIVER ST
Second Line :
City : ELYRIA
State : OH
Zip : 44035-5902
Country : US
Telephone Number : 440-329-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2025
Last Update Date : 04/08/2026

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Directions to “ RAILEY HERREN ” Practice Location

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