Provider Demographics
NPI:1891963575
Name:RAYNOR, LUTHER KENNITH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LUTHER
Middle Name:KENNITH
Last Name:RAYNOR
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:226 CARTWRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-3902
Mailing Address - Country:US
Mailing Address - Phone:478-952-7227
Mailing Address - Fax:478-929-8528
Practice Address - Street 1:226 CARTWRIGHT DR
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005-3902
Practice Address - Country:US
Practice Address - Phone:478-952-7227
Practice Address - Fax:478-929-8528
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA14850208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice