Provider Demographics
NPI:1508844937
Name:RABY, LON F JR (MD)
Entity Type:Individual
Prefix:MR
First Name:LON
Middle Name:F
Last Name:RABY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4021 BALMORAL DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6403
Mailing Address - Country:US
Mailing Address - Phone:256-539-2741
Mailing Address - Fax:256-539-2775
Practice Address - Street 1:4021 BALMORAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6403
Practice Address - Country:US
Practice Address - Phone:256-539-2741
Practice Address - Fax:256-539-2775
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL19976207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51026642OtherBCBS OF AL
F59634Medicare UPIN