Healthcare Provider Details

I. General information

NPI: 1609829431
Provider Name (Legal Business Name): RICHARD D RANNE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 06/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 S WHEELING AVE STE 606
TULSA OK
74104
US

IV. Provider business mailing address

1919 S WHEELING AVE STE 606
TULSA OK
74104-5635
US

V. Phone/Fax

Practice location:
  • Phone: 918-748-7878
  • Fax: 918-403-6326
Mailing address:
  • Phone: 918-748-7878
  • Fax: 918-403-6326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number17126
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: