Healthcare Provider Details

I. General information

NPI: 1003982554
Provider Name (Legal Business Name): RON K. RANKIN, M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W 14TH AVE
AMARILLO TX
79101-4140
US

IV. Provider business mailing address

PO BOX 50366
AMARILLO TX
79159-0366
US

V. Phone/Fax

Practice location:
  • Phone: 806-622-2725
  • Fax: 806-352-4887
Mailing address:
  • Phone: 806-352-4887
  • Fax: 806-352-4887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberK5385
License Number StateTX

VIII. Authorized Official

Name: DR. RON K. RANKIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 806-622-2725