Individual
DEXTER LAMAR RAYSOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
402 JACKSON ST, SUFFOLK, VA 23434-5315
(757) 539-3730
Mailing address
402 JACKSON ST, SUFFOLK, VA 23434
(757) 539-3730
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
—
GA
363AM0700X
Medical Physician Assistant
Primary
—
NC
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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