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General NPI Number Information
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NPI Number | 1740407014
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Entity Type | Organization
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Legal Business Name | JOE HUNDLEY RANKIN MD A PROF MEDICAL CORP
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 1020 W FERTITTA BLVD
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City | LEESVILLE
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State | LA
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Zip | 71446-4645
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Country | US
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Telephone | 660-826-5960
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1547
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City | SEDALIA
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State | MO
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Zip | 65302-1547
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Country | US
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Telephone | 660-826-5960
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Fax | 660-826-4852
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Authorized Official
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Title or Position | OWNER
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Name | JOE RANKIN
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Credential | MD
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Telephone | 660-826-5960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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