Individual
KY RAYMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
77 NEALY AVE, HAMPTON, VA 23665-2040
(757) 225-7630
Mailing address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0102207650
VA
208D00000X
General Practice Physician
0102207650
VA
208D00000X
General Practice Physician
208D00000X
NV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234567
—
TX
Enumeration date
03/01/2021
Last updated
06/14/2025
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