Individual
RAYNI L TEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3126 WISCONSIN AVE, JOPLIN, MO 64804-2873
(417) 626-7337
(417) 731-3082
Mailing address
3126 WISCONSIN AVE, JOPLIN, MO 64804-2873
(417) 626-7337
(417) 731-3082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2005013271
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200067460A
—
OK
05
—
200353680A
—
KS
01
—
200692
ANTHEM
MO
05
—
207458001
—
MO
01
—
P00259947
RR MEDICARE
—
Enumeration date
07/03/2006
Last updated
03/15/2011
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