Provider Demographics
NPI:1831222397
Name:RAYL, WILLIAM ARTHUR (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ARTHUR
Last Name:RAYL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 N 6TH E
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:ID
Mailing Address - Zip Code:83647-2208
Mailing Address - Country:US
Mailing Address - Phone:208-587-8441
Mailing Address - Fax:
Practice Address - Street 1:960 N 6TH E
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:ID
Practice Address - Zip Code:83647-2208
Practice Address - Country:US
Practice Address - Phone:208-587-8441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010150366OtherBLUE CROSS
IDC4553OtherBLUE CROSS
ID1580518Medicare ID - Type UnspecifiedMEDICARE NUMBER
IDU72363Medicare UPIN