MEDICARE: DR. JOHN GORDON RAWLES JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0106X	Orthopaedic Hand Surgery Physician	101030205	VA
2	207X00000X	Orthopaedic Surgery Physician	101030205	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	200018854	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31725	OTHER	VA	SH CARENET
3	386539	OTHER	VA	ANTHEM WEST END OPERATORY
4	540885859	OTHER	VA	PRIVATE HEALTHCARE SYSTEM
5	042940	OTHER	VA	ANTHEM HEALTHKEEPERS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	2138341	OTHER	VA	UNITED HEALTHCARE MAMSI
8	48193	OTHER	VA	OPTIMA HEALTH
9	540885859	OTHER	VA	CIGNA
10	540885859	OTHER	VA	COMPMANAGEMENT
11	540885859	OTHER	VA	FOCUS
12	540885859	OTHER	VA	C&O EMPLOYEE'S HEALTHCARE
13	0536807	OTHER	VA	AETNA HMO
14	540885859	OTHER	VA	CORVEL
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
16	285556	OTHER	VA	SOUTHERN HEALTH
17	0900105	OTHER	VA	UNITED HEALTHCARE
18	540885859	OTHER	VA	FIRST HEALTH/CCN

General Provider Information

NPI Number	:	1225077548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN GORDON RAWLES JR. M.D.

Provider Business Mailing Address
First Line	:	1115 BOULDERS PKWY
Second Line	:	SUITE 200
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-4067
Country	:	US
Telephone Number	:	804-560-5595
Fax Number	:	804-560-9029

Provider Business Practice Location Address
First Line	:	1400 JOHNSTON WILLIS DR
Second Line	:	SUITE A
City	:	RICHMOND
State	:	VA
Zip	:	23235-4765
Country	:	US
Telephone Number	:	804-379-8088
Fax Number	:	804-794-6067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	01/29/2013

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Practice Location Address:

1400 JOHNSTON WILLIS DR , STE B
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23235-4765

Practice Phone: 804-379-3840
Practice Fax: 804-379-9567

1306885777 — DANIELLE E WILLIAMS D.O.T.
Practice Location Address:

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RICHMOND, VA
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Practice Fax: 804-379-9567

1487696472 — CYNTHIA YORK KING D.P.T.
Practice Location Address:

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RICHMOND, VA
23235-4765

Practice Phone: 804-379-3840
Practice Fax: 804-379-9567

1265475792 — DR. CHARLES WILLIAM VOKAC M.D.
Practice Location Address:

1400 JOHNSTON WILLIS DR , SUITE A
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Practice Fax: 804-794-6067

1023051604 — DR. DAVID DANIEL NEDEFF M.D.
Practice Location Address:

1400 JOHNSTON WILLIS DR , SUITE A
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1740216746 — DR. BARRY WEBSTER BURKHARDT M.D.
Practice Location Address:

1400 JOHNSTON WILLIS DR , SUITE A
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Practice Phone: 804-379-8088
Practice Fax: 804-794-6067

Directions to “ DR. JOHN GORDON RAWLES JR. M.D.” Practice Location

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