=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780661355
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PETER C RAWLINGS MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2005
-----------------------------------------------------
Last Update Date | 01/14/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 725 GLENWOOD DR SUITE 882
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37404-1163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-698-2229
-----------------------------------------------------
Fax | 423-624-2652
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 725 GLENWOOD DR SUITE 882
-----------------------------------------------------
City | CHATTANOOGA
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37404-1163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-698-2229
-----------------------------------------------------
Fax | 423-624-2652
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 13264
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------