Basic Information
| Provider Information | |||||||||
| NPI: | 1346205283 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAWLINGS | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | CHARLES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 CHAMBER CENTER DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LAKESIDE PARK | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410171673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593445555 | ||||||||
| FaxNumber: | 8593348707 | ||||||||
| Practice Location | |||||||||
| Address1: | 1980 LITTON LN | ||||||||
| Address2: | |||||||||
| City: | HEBRON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410488669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593348700 | ||||||||
| FaxNumber: | 8593348707 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2006 | ||||||||
| LastUpdateDate: | 06/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 38928 | KY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 64097132 | 05 | KY | MEDICAID | 2605194 | 05 | OH | MEDICAID |