Provider Demographics
NPI:1598964793
Name:RAWLS, JAMES ALTON JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALTON
Last Name:RAWLS
Suffix:JR
Gender:M
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:PO BOX 1837
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32348-7314
Mailing Address - Country:US
Mailing Address - Phone:850-584-6037
Mailing Address - Fax:850-584-1711
Practice Address - Street 1:1 BUCKEYE DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-7702
Practice Address - Country:US
Practice Address - Phone:850-584-1353
Practice Address - Fax:850-584-1711
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME10788208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice