Provider Demographics
NPI:1366676223
Name:RANNEY, NATHANIEL ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:ROBERT
Last Name:RANNEY
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 1:131 CHEROKEE ROSE LN STE B
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7244
Mailing Address - Country:US
Mailing Address - Phone:985-871-1721
Mailing Address - Fax:985-893-6908
Practice Address - Street 1:131 CHEROKEE ROSE LN STE B
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7244
Practice Address - Country:US
Practice Address - Phone:985-871-1721
Practice Address - Fax:985-893-6908
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207661207RG0100X, 207RI0008X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine