Healthcare Provider Details

I. General information

NPI: 1568517985
Provider Name (Legal Business Name): GARY A RANKIN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 MAPLE ST
GREENSBORO NC
27405-6911
US

IV. Provider business mailing address

1204 MAPLE ST
GREENSBORO NC
27405-6911
US

V. Phone/Fax

Practice location:
  • Phone: 336-294-8258
  • Fax: 336-292-4109
Mailing address:
  • Phone: 336-294-8258
  • Fax: 336-292-4109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. TERESA H ALEXANDER
Title or Position: PRACTICE MANAGER
Credential: RN
Phone: 336-294-8258