Basic Information
Provider Information
NPI: 1184035362
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAWSON
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5959 S SHERWOOD FOREST BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708166038
CountryCode: US
TelephoneNumber: 2255260011
FaxNumber: 2257659196
Practice Location
Address1: 8200 CONSTANTIN BLVD FL 4
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708093481
CountryCode: US
TelephoneNumber: 2257655500
FaxNumber: 2257651202
Other Information
ProviderEnumerationDate: 05/10/2014
LastUpdateDate: 05/27/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/27/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X323809LAN Allopathic & Osteopathic PhysiciansPediatrics 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
2080P0210X323809LAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology

No ID Information.


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