Provider Demographics
NPI:1265531321
Name:MAURICE S. RAWLINGS, JR., M.D., P.C.
Entity type:Organization
Organization Name:MAURICE S. RAWLINGS, JR., M.D., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAWLINGS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:423-698-0304
Mailing Address - Street 1:605 GLENWOOD DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1108
Mailing Address - Country:US
Mailing Address - Phone:423-698-0304
Mailing Address - Fax:423-622-7068
Practice Address - Street 1:605 GLENWOOD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1108
Practice Address - Country:US
Practice Address - Phone:423-698-0304
Practice Address - Fax:423-622-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD 00000101562086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3183814Medicaid
TN3383427Medicare ID - Type Unspecified
TN3183814Medicaid