Provider Demographics
NPI:1770941171
Name:RAWLINS, SEKOU (PA)
Entity type:Individual
Prefix:
First Name:SEKOU
Middle Name:
Last Name:RAWLINS
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:479-709-7430
Mailing Address - Fax:479-573-2563
Practice Address - Street 1:923 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-4943
Practice Address - Country:US
Practice Address - Phone:479-709-7080
Practice Address - Fax:479-709-7081
Is Sole Proprietor?:No
Enumeration Date:2016-02-01
Last Update Date:2024-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARPA-1302363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1770941171Medicaid
NC1770941171Medicaid