Healthcare Provider Details
I. General information
NPI: 1225027865
Provider Name (Legal Business Name): DAVID MICHAEL RANKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/17/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 BLOUNT AVE STE 101
KNOXVILLE TN
37920
US
IV. Provider business mailing address
101 BLOUNT AVE SUITE 740
KNOXVILLE TN
37920
US
V. Phone/Fax
- Phone: 865-632-5885
- Fax: 865-632-5893
- Phone: 865-632-5885
- Fax: 865-632-5893
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD11391 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: