MEDICARE: NATHANIEL ROBERT RANNEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	207661	LA
2	207RI0008X	Hepatology Physician	207661	LA
3	207R00000X	Internal Medicine Physician	207661	LA

General Provider Information

NPI Number	:	1366676223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANIEL ROBERT RANNEY M.D.

Provider Business Mailing Address
First Line	:	131 CHEROKEE ROSE LN STE B
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-7244
Country	:	US
Telephone Number	:	985-871-1721
Fax Number	:	985-893-6908

Provider Business Practice Location Address
First Line	:	131 CHEROKEE ROSE LN STE B
Second Line	:
City	:	COVINGTON
State	:	LA
Zip	:	70433-7244
Country	:	US
Telephone Number	:	985-871-1721
Fax Number	:	985-893-6908

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	07/13/2015

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