Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 012223 | LA |
NPI | 1003887100 |
---|---|
Provider Name | Dr. John M Rainey |
First Address | Lafayette, LA 70506-4665 |
Second Address | Lafayette, LA 70506-4600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1182869 | (05) | LA |
B65389 | (02) | LA |