Organization
STEPHEN D. RAINES
Active
Other names
Raines Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY W. RAINES (OFFICE MANAGER)
(731) 885-0220
Entity
Organization
Contact information
Practice address
1901 COOK ST, DYERSBURG, TN 38024-1882
(731) 286-2139
(731) 286-2201
Mailing address
1415 E REELFOOT AVE, UNION CITY, TN 38261-5812
(731) 885-0220
(731) 885-0216
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
DPM 658
TN
213ES0131X
Foot Surgery Podiatrist
Primary
DPM217
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548228620
NPI
TN
01
—
1568496172
NPI
TN
01
—
1790999456
DME NPI
TN
05
—
3350896
—
TN
05
—
3354277
—
TN
Enumeration date
03/09/2007
Last updated
11/21/2008
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