Individual
DR. BRUCE EDWARD RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
390 GRIFFITH ST, PINEVILLE, LA 71360
(318) 493-6323
(318) 443-6189
Mailing address
390 GRIFFITH ST, PINEVILLE, LA 71360
(318) 443-6323
(318) 443-6189
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
018519
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1911895
—
LA
Enumeration date
10/21/2006
Last updated
07/08/2007
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