Organization Active NPI

E. Craig Raby MD PA

  • Procedural Dermatology Physician
  • Palatka, FL
National Provider Identifier
1508951658
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
ME 18390 Issued in FL
Legal business name
E. CRAIG RABY MD PA
Practice address
310 S Palm Ave
Suite 10
Palatka, FL 32177-4179
Phone
(386) 328-5746
NPI assigned
Oct 4, 2006
Last updated
Jan 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Elliott Craig Raby, MD
Title
President
Phone
(386) 328-5746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X ME 18390 FL Primary

Addresses

Primary practice location

310 S Palm Ave
Suite 10
Palatka, FL 32177-4179

Mailing address

310 S Palm Ave
Suite 10
Palatka, FL 32177-4179
Phone (386) 328-5746

National Provider Directory

National Provider Directory

Locations

310 S Palm Ave
Ste 10
Palatka, FL 32177
Phone (386) 328-5746

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1508951658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S PALM AVE",
            "address_2": "SUITE 10",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774179",
            "telephone_number": "386-328-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S PALM AVE",
            "address_2": "SUITE 10",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774179",
            "telephone_number": "386-328-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. CRAIG RABY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "RABY",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-328-5746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "ME 18390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.