Individual
JONATHAN H.S. RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 LINCOLN PKWY STE 103, HATTIESBURG, MS 39402-3261
(601) 261-1600
(601) 264-5133
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 261-1600
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
27015
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08820253
—
MS
Enumeration date
04/03/2014
Last updated
07/08/2020
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