Provider Demographics
NPI:1275891996
Name:RANKER, CHASE RICHARD (DPM)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:RICHARD
Last Name:RANKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 HASKINS RD STE A
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1638
Mailing Address - Country:US
Mailing Address - Phone:419-352-8110
Mailing Address - Fax:
Practice Address - Street 1:735 HASKINS RD STE A
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-1638
Practice Address - Country:US
Practice Address - Phone:419-352-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36003736213E00000X
OH36.003736213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0123318Medicaid
OHH357741Medicare PIN
OH0123318Medicaid