Provider Demographics
NPI:1619156916
Name:RAYLAND K. BEURLOT, M.D., APMC
Entity Type:Organization
Organization Name:RAYLAND K. BEURLOT, M.D., APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYLAND
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:BEURLOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-473-9050
Mailing Address - Street 1:PO BOX 12787
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71315-2787
Mailing Address - Country:US
Mailing Address - Phone:318-473-9050
Mailing Address - Fax:318-473-0086
Practice Address - Street 1:2495 SHREVEPORT HWY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4044
Practice Address - Country:US
Practice Address - Phone:318-473-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1619156916OtherORGANIZATION NPI
5BC72OtherMEDICARE GROUP PTAN