Provider Demographics
NPI:1073682340
Name:RANCK, ERIN M (DO)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:RANCK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5400 DUPONT CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-2793
Mailing Address - Country:US
Mailing Address - Phone:513-576-7700
Mailing Address - Fax:513-576-1018
Practice Address - Street 1:2020 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-1696
Practice Address - Country:US
Practice Address - Phone:513-732-5088
Practice Address - Fax:513-231-2620
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.010848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2745444Medicaid
KY64044951Medicaid
KYP00374142OtherRAILROAD MEDICARE
OHH53811Medicare PIN
OH2745444Medicaid
OHH538314Medicare PIN
OHH538310Medicare PIN
KYG02295Medicare UPIN
OHH53813Medicare PIN
KYP00374142OtherRAILROAD MEDICARE