Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Willie P Rajvong

Individual provider Medical Technologist · NPI 1992373013

Willie P Rajvong is a Medical Technologist in Statesboro, Georgia. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
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Practice location Address checks out

1332 Southern Dr
Statesboro, GA 30460-1360
Phone: (912) 478-4636
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Medical Technologist Taxonomy 246QM0706X

Record details

NPI number1992373013
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 15, 2021
Last updated in NPPESJune 15, 2021
Certification dateJune 15, 2021
Mailing address350 Rucker Ln Apt 555, Statesboro, GA 30458-3241

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