Provider Demographics
NPI:1235121989
Name:RANGER, WILLIAM RATIGAN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RATIGAN
Last Name:RANGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 HENSON AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1510
Mailing Address - Country:US
Mailing Address - Phone:269-492-6500
Mailing Address - Fax:269-492-6461
Practice Address - Street 1:1815 HENSON AVE
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048
Practice Address - Country:US
Practice Address - Phone:269-492-6500
Practice Address - Fax:269-492-6461
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIWR05847208600000X
MI43010584722086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4211489Medicaid
MI1235121989Medicaid
MI47-2491035OtherNEW TAX ID 47-2491035
MI38-3309299OtherNEW TAX ID#
MI381961572OtherFEDERAL TAX ID NUMBER