Provider Demographics
NPI:1174789929
Name:GILES, RAYMOND A (DPM)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:A
Last Name:GILES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 KENNEDY DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2260
Mailing Address - Country:US
Mailing Address - Phone:615-896-9493
Mailing Address - Fax:615-494-4956
Practice Address - Street 1:1508 CARL ADAMS DR STE 102
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4375
Practice Address - Country:US
Practice Address - Phone:615-896-9493
Practice Address - Fax:615-494-4956
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN719213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery