Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 17126 | OK |
NPI | 1609829431 |
---|---|
Provider Name | Richard D Ranne |
First Address | Tulsa, OK 74104-5635 |
Second Address | Tulsa, OK 74104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 13/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
217444301 | (05) | TX |
56709048 | (05) | NM |
8CN624 | BCBS (01) | TX |
C51948 | (02) | TX |