Provider Demographics
NPI:1548244403
Name:RATHBURN, CHRIS B (MD)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:B
Last Name:RATHBURN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 551308
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32255-1308
Mailing Address - Country:US
Mailing Address - Phone:904-493-3333
Mailing Address - Fax:904-493-2222
Practice Address - Street 1:7011 A C SKINNER PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6954
Practice Address - Country:US
Practice Address - Phone:904-622-9035
Practice Address - Fax:904-493-2222
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43492207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00677713OtherRAILROAD MEDICARE
FLP00677713OtherRAILROAD MEDICARE
FLD27786Medicare UPIN