Provider Demographics
NPI:1801890751
Name:BEURLOT, RAYLAND KEVIN (MD)
Entity type:Individual
Prefix:DR
First Name:RAYLAND
Middle Name:KEVIN
Last Name:BEURLOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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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:184-730-0103
Practice Address - Fax:318-445-3510
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA20112208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA20112OtherLA LICENSE
LA1958778Medicaid
AL72-1246297OtherOCHSNER
LA260040912OtherRAILROAD MEDICARE
LA5R012BC72OtherMEDICARE PTAN
TXK6989OtherTX STATE LICENSE