Individual
MR. TIMOTHY M RAYCOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
411 S KEELER, AB-02-234C, PHILLIPS 66 HEALTH SERVICES, BARTLESVILLE, OK 74003-6670
(918) 661-6811
(918) 977-8005
Mailing address
402452 W 2200 RD, BARTLESVILLE, OK 74006-0448
(832) 477-0379
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2136
OK
363A00000X
Physician Assistant
PA04283
TX
Other
Enumeration date
01/31/2006
Last updated
08/01/2012
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