Provider Demographics
NPI:1063413862
Name:PAINE, RAYMOND L (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:L
Last Name:PAINE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 PARK WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4202
Mailing Address - Country:US
Mailing Address - Phone:865-690-8190
Mailing Address - Fax:865-531-3536
Practice Address - Street 1:9401 PARK WEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4202
Practice Address - Country:US
Practice Address - Phone:865-690-8190
Practice Address - Fax:865-531-3536
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0118332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B03517Medicare UPIN