Individual
DR. KEVIN KYLE RAYMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
126 E MAIN ST STE B, PAYSON, AZ 85541-5488
(928) 472-4675
(928) 472-3431
Mailing address
PO BOX 859, PAYSON, AZ 85547-0859
(928) 472-4675
(928) 472-3431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
04-32629
KS
207Q00000X
Family Medicine Physician
Primary
44721
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110150004
MEDICARE
KS
01
—
110171004
MEDICARE
KS
05
—
200573240A
—
KS
05
—
623101
—
AZ
Enumeration date
05/01/2007
Last updated
10/05/2011
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