Provider Demographics
NPI:1700832508
Name:RAWLINGS, RICHARD R (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:DO
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 25041
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85002-5041
Mailing Address - Country:US
Mailing Address - Phone:480-834-4860
Mailing Address - Fax:480-610-1756
Practice Address - Street 1:9001 N 28TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4702
Practice Address - Country:US
Practice Address - Phone:480-834-4860
Practice Address - Fax:480-610-1756
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ101859Medicaid
AZ101859Medicaid
AZZ131756Medicare PIN