Provider Demographics
NPI:1538385745
Name:KEVIN RAYLS, M.D., PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:KEVIN RAYLS, M.D., PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-485-3640
Mailing Address - Street 1:10300 W CHARLESTON BLVD
Mailing Address - Street 2:#13-180
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1037
Mailing Address - Country:US
Mailing Address - Phone:702-796-0022
Mailing Address - Fax:
Practice Address - Street 1:9280 W SUNSET RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-796-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101163Medicare ID - Type Unspecified