Provider Demographics
NPI:1336274810
Name:RAINER, JONATHAN CLAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CLAY
Last Name:RAINER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3280 DAUPHIN ST BLDG A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4060
Mailing Address - Country:US
Mailing Address - Phone:251-626-0732
Mailing Address - Fax:251-272-1983
Practice Address - Street 1:27961 US HIGHWAY 98 STE 10
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4718
Practice Address - Country:US
Practice Address - Phone:251-626-0732
Practice Address - Fax:251-272-1983
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2014-09-10
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Provider Licenses
StateLicense IDTaxonomies
AL26411208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL113946Medicaid
AL528700580OtherGROUP MEDICAID
AL113946Medicaid