Provider Demographics
NPI:1013409770
Name:DAVID TRAYNOR, MD PC
Entity Type:Organization
Organization Name:DAVID TRAYNOR, MD PC
Other - Org Name:GLENEAGLES FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-881-5880
Mailing Address - Street 1:1102 GLENEAGLES DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6404
Mailing Address - Country:US
Mailing Address - Phone:256-881-5880
Mailing Address - Fax:256-883-3280
Practice Address - Street 1:1102 GLENEAGLES DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6404
Practice Address - Country:US
Practice Address - Phone:256-881-5880
Practice Address - Fax:256-883-3280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty