Provider Demographics
NPI:1225064801
Name:RANSOM, WILLARD B (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:B
Last Name:RANSOM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1418 S MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3543
Mailing Address - Country:US
Mailing Address - Phone:785-242-1620
Mailing Address - Fax:785-242-3825
Practice Address - Street 1:1418 S MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3543
Practice Address - Country:US
Practice Address - Phone:785-242-1620
Practice Address - Fax:785-242-3825
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-18458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4630851OtherAETNA
KS13777014OtherKANSAS CITY BC/BS
KS610221OtherHEALTHWAVE
KS3211285002OtherCIGNA PROVIDER NUMBER
KY01308OtherKANSAS BLUE CROSS BLUE SH
KS3211285002OtherCIGNA PROVIDER NUMBER
KSB91038Medicare UPIN