Individual
MR. DIRK TIMOTHY RAINWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 WATTS ST, JONESBORO, LA 71251-2053
(318) 259-1569
(318) 259-8523
Mailing address
103 WATTS ST, JONESBORO, LA 71251-2053
(318) 259-1569
(318) 259-8523
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
025000
LA
208D00000X
General Practice Physician
Primary
MD.025000
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1423459
—
LA
Enumeration date
02/27/2006
Last updated
09/04/2019
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