Healthcare Provider Details

I. General information

NPI: 1588332373
Provider Name (Legal Business Name): STEPHEN WILLIAM RAWSON ARRT(R)(MR)
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2021
Last Update Date: 09/06/2021
Certification Date: 09/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 BEECHBROOK CT
UNICOI TN
37692-6441
US

IV. Provider business mailing address

103 BEECHBROOK CT
UNICOI TN
37692-6441
US

V. Phone/Fax

Practice location:
  • Phone: 423-381-5821
  • Fax:
Mailing address:
  • Phone: 423-381-5821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: