Individual
DR. WALTER RAYFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD., FACS
Contact information
Practice address
6029 WALNUT GROVE RD, SUITE 300, MEMPHIS, TN 38120-2112
(901) 767-8158
(901) 767-1555
Mailing address
6029 WALNUT GROVE RD, SUITE 300, MEMPHIS, TN 38120-2112
(901) 767-8158
(901) 767-1555
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
19176
MS
208800000X
Urology Physician
40580
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00127083
—
MS
05
—
3336328
—
TN
01
—
4169189
BCBS
TN
01
—
512I340011
MS MEDICARE PTAN
MS
01
—
C00393
MS MEDICARE GROUP NUMBER
MS
Enumeration date
08/19/2006
Last updated
07/17/2008
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