Individual
FREDERICK BRONN RAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 W 4TH ST, SUITE 200, COOKEVILLE, TN 38501-2448
(931) 528-1575
(931) 526-2962
Mailing address
100 W 4TH ST, SUITE 200, COOKEVILLE, TN 38501-2448
(931) 528-1575
(931) 526-2962
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19380
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3044672
—
TN
Enumeration date
05/02/2006
Last updated
07/08/2007
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