Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 03153 | KY |
Y | 207Q00000X | Family Doctor | 34008447 | OH |
N | 207QS0010X | Family Doctor - Sports Medicine | 03153 | KY |
NPI | 1235166083 |
---|---|
Provider Name | Dr. Wade M Rankin |
First Address | Cincinnati, OH 45237-6147 |
Second Address | Cincinnati, OH 45230-2187 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 04/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2605149 | (05) | OH |
7100070340 | (05) | KY |
I31653 | (02) | OH |