MEDICARE: R. RYAN RAWLINGS, DO, PLC

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	2084N0400X	Neurology Physician	4100	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568611606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R. RYAN RAWLINGS, DO, PLC

Provider Business Mailing Address
First Line	:	PO BOX 25041
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85002-5041
Country	:	US
Telephone Number	:	480-834-4860
Fax Number	:	480-610-1756

Provider Business Practice Location Address
First Line	:	9001 N 28TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-4702
Country	:	US
Telephone Number	:	480-834-4860
Fax Number	:	480-610-1756

Authorized Official
Title or Position	:	CEO
Name	:	DR. RICHARD RYAN RAWLINGS
Credential	:	DO
Telephone Number	:	480-834-4860

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	12/15/2009

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