Provider Demographics
NPI:1487886735
Name:RAYNOR, ANTHONY WARD (PA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WARD
Last Name:RAYNOR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:151 HAROLD FLEMING CT
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-4225
Mailing Address - Country:US
Mailing Address - Phone:864-573-6320
Mailing Address - Fax:864-208-0352
Practice Address - Street 1:336 DEERFIELD RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5008
Practice Address - Country:US
Practice Address - Phone:828-262-4100
Practice Address - Fax:828-262-4103
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2018-10-30
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Provider Licenses
StateLicense IDTaxonomies
SC1396207RP1001X
NC0010-01563363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease