Healthcare Provider Details

I. General information

NPI: 1124065560
Provider Name (Legal Business Name): STEVEN SCOTT RANZENBERGER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 S 4TH ST STE 200
LEAVENWORTH KS
66048-5009
US

IV. Provider business mailing address

3550 S 4TH ST STE 200
LEAVENWORTH KS
66048-5009
US

V. Phone/Fax

Practice location:
  • Phone: 913-680-6442
  • Fax: 913-351-1346
Mailing address:
  • Phone: 913-680-6442
  • Fax: 913-351-1346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0523674
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: