Provider Demographics
NPI:1114630795
Name:RAYNE, DOUGLAS ALEXANDER
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ALEXANDER
Last Name:RAYNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SPUR DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1300
Mailing Address - Country:US
Mailing Address - Phone:757-940-6533
Mailing Address - Fax:
Practice Address - Street 1:105 SPUR DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1300
Practice Address - Country:US
Practice Address - Phone:757-940-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriver