Provider Demographics
NPI:1366433872
Name:RAYNER, LINDA JOANNE (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JOANNE
Last Name:RAYNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 GEORGETOWN SQ
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6205
Mailing Address - Country:US
Mailing Address - Phone:770-457-4677
Mailing Address - Fax:
Practice Address - Street 1:4370 GEORGETOWN SQ
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6205
Practice Address - Country:US
Practice Address - Phone:770-457-4677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA08BBXNMMedicare PIN
GAG85129Medicare UPIN