Healthcare Provider Details

I. General information

NPI: 1730120973
Provider Name (Legal Business Name): JENNIFER A RANTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 MAIN ST STE 200
HELLERTOWN PA
18055-1513
US

IV. Provider business mailing address

PO BOX 783311
PHILADELPHIA PA
19178-3311
US

V. Phone/Fax

Practice location:
  • Phone: 610-838-7069
  • Fax: 610-838-7060
Mailing address:
  • Phone: 484-884-4500
  • Fax: 484-884-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD444623
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: