Provider Demographics
NPI:1205978368
Name:RAWLINGS, MARSDEN KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:MARSDEN
Middle Name:KEITH
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 PEABODY AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-2821
Mailing Address - Country:US
Mailing Address - Phone:214-421-7848
Mailing Address - Fax:
Practice Address - Street 1:1906 PEABODY AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-2821
Practice Address - Country:US
Practice Address - Phone:214-421-7848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAP8B179837Medicaid
LA89G957Medicare ID - Type Unspecified
LAP8B179837Medicaid