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Individual

JEFFREY M RAYBORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9000 N MAIN ST, SUITE 227, DAYTON, OH 45415-1180
(513) 631-0763
Mailing address
9000 N MAIN ST, SUITE 227, DAYTON, OH 45415-1180
(513) 631-0763

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
35-091584
OH
390200000X
Student in an Organized Health Care Education/Training Program
57010570
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2969640
OH
01
57010570
MD TRAINING CERTIFICATE
OH
Enumeration date
06/13/2007
Last updated
11/27/2013
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