Basic Information
| Provider Information | |||||||||
| NPI: | 1891857397 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAYNOR | ||||||||
| FirstName: | DANFORD | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | II | ||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 757 NC HWY 24/27 BYPASS EAST | ||||||||
| Address2: | |||||||||
| City: | ALBEMARLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280015349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049832431 | ||||||||
| FaxNumber: | 7049832434 | ||||||||
| Practice Location | |||||||||
| Address1: | 757 NC HWY 24/27 BYPASS EAST | ||||||||
| Address2: | |||||||||
| City: | ALBEMARLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280015349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049832431 | ||||||||
| FaxNumber: | 7049832434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1464 | NC | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 0853510001 | 01 | NC | PGBA | OTHER | 0908E | 01 | NC | BLUE CROSS BLUE SHIELD | OTHER | 0853510001 | 01 | NC | CIGNA GOVERNMENT SERVICES MEDICARE PART B DME | OTHER | 410034018 | 01 | NC | RAILROAD MEDICARE | OTHER | 1037 | 01 | NC | OPTICARE | OTHER | 8909280 | 05 | NC | MEDICAID | FH7000055 | 01 | NC | FIRST HEALTH | OTHER | 77006 | 01 | NC | MEDCOST | OTHER |