Doctor Name: | LARRY DEAN RAFEY |
NPI Number: | 1437195955 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 3233 |
Business Practice Address: | 4415 Us Highway 331 S Defuniak Springs, FL - 324356307 |
Business Phone Number: | 8509514556 |
Business Fax Number: | 8509514527 |
Mailing Address: | 4415 Us Highway 331 S, DEFUNIAK SPRINGS |
State: | FL |
Postal Code: | 324356307 |
Phone Number: | 8509514556 |
Fax Number: | 8509514527 |
NPI Enumeration Date: | 06/22/2006 |
NPI Last Update Date: | 06/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 3233 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |