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General NPI Number Information
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NPI Number | 1871331983
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Entity Type | Individual
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Provider Name | CODY JACK RANKIN PA
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Gender | Male
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Dates
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Enumeration Date | 07/15/2024
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 590 MEDICAL CENTER ROAD
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City | FORT HOOD
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State | TX
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Zip | 76544
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Country | US
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Telephone | 208-520-9311
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 VERNICE DR
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City | COPPERAS COVE
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State | TX
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Zip | 76522-7593
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Country | US
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Telephone | 208-520-9311
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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