Provider Demographics
NPI:1467565515
Name:CAIN, RUFUS HAYNES
Entity Type:Individual
Prefix:
First Name:RUFUS
Middle Name:HAYNES
Last Name:CAIN
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:PO BOX 2257
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28353-2257
Mailing Address - Country:US
Mailing Address - Phone:910-610-4011
Mailing Address - Fax:910-276-0571
Practice Address - Street 1:999 CHERAW ST
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-2420
Practice Address - Country:US
Practice Address - Phone:843-479-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC113889Medicaid
SCE96742Medicare UPIN
SC113889Medicaid
SCSC55921850Medicare PIN