Provider Demographics
NPI:1225077548
Name:RAWLES, JOHN GORDON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GORDON
Last Name:RAWLES
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:1400 JOHNSTON WILLIS DR
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4765
Practice Address - Country:US
Practice Address - Phone:804-379-8088
Practice Address - Fax:804-794-6067
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2013-01-29
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Provider Licenses
StateLicense IDTaxonomies
VA101030205207XS0106X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA31725OtherSH CARENET
VA200018854OtherRAILROAD MEDICARE
VA386539OtherANTHEM WEST END OPERATORY
VA540885859OtherPRIVATE HEALTHCARE SYSTEM
VA042940OtherANTHEM HEALTHKEEPERS
VA1225077548Medicaid
VA2138341OtherUNITED HEALTHCARE MAMSI
VA48193OtherOPTIMA HEALTH
VA540885859OtherCIGNA
VA540885859OtherCOMPMANAGEMENT
VA540885859OtherFOCUS
VA540885859OtherC&O EMPLOYEE'S HEALTHCARE
VA0536807OtherAETNA HMO
VA540885859OtherCORVEL
VA006441769Medicaid
VA285556OtherSOUTHERN HEALTH
VA0900105OtherUNITED HEALTHCARE
VA540885859OtherFIRST HEALTH/CCN
VA540885859OtherCORVEL
VA48193OtherOPTIMA HEALTH
VA540885859OtherC&O EMPLOYEE'S HEALTHCARE