Provider Demographics
NPI:1073581864
Name:RANGINENI, RAJAGOPAL R (MD)
Entity Type:Individual
Prefix:
First Name:RAJAGOPAL
Middle Name:R
Last Name:RANGINENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:902 N RIVERSIDE RD
Mailing Address - Street 2:STE 200
Mailing Address - City:ST JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2559
Mailing Address - Country:US
Mailing Address - Phone:816-271-1301
Mailing Address - Fax:816-271-1302
Practice Address - Street 1:902 N RIVERSIDE RD
Practice Address - Street 2:STE 200
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2559
Practice Address - Country:US
Practice Address - Phone:816-271-1301
Practice Address - Fax:816-271-1302
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0423186207RX0202X
MOR3D52207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS076129OtherBCBS OF KS FOR MO LOCATIO
KS100202480AOtherKANSAS MEDICAID
MO10102028OtherBLUE CROSS BLUE SHIELD
MO1073581864Medicaid
MOP00859666OtherRR MEDICARE
KS056938OtherBCBS OF KS FOR KS LOCATIO
MO1073581864Medicaid
KS076129OtherBCBS OF KS FOR MO LOCATIO
MO10102028OtherBLUE CROSS BLUE SHIELD