Basic Information
| Provider Information | |||||||||
| NPI: | 1447519905 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAYSON | ||||||||
| FirstName: | ROBERT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | ACC CLINIC CB 7705 | ||||||||
| Address2: | 102 MASON FARM RD | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661459 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2121 E HARMONY RD UNIT 100 | ||||||||
| Address2: | |||||||||
| City: | FORT COLLINS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805283401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702211000 | ||||||||
| FaxNumber: | 9702976886 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2012 | ||||||||
| LastUpdateDate: | 06/11/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2015-00600 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0011X | DR.0064012 | CO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 390200000X | 182456 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RC0000X | DR.0064012 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.