Healthcare Provider Details

I. General information

NPI: 1487838983
Provider Name (Legal Business Name): RANKIN PLASTIC SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 CROSSGATES BLVD SUITE 2400
BRANDON MS
39042-2700
US

IV. Provider business mailing address

348 CROSSGATES BLVD SUITE 2400
BRANDON MS
39042-2700
US

V. Phone/Fax

Practice location:
  • Phone: 601-824-3977
  • Fax: 601-824-3979
Mailing address:
  • Phone: 601-824-3977
  • Fax: 601-824-3979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BRAD SINCLAIR
Title or Position: REGIONAL DIRECTOR
Credential:
Phone: 866-817-2764