Provider Demographics
NPI:1497757124
Name:RANKIN ORTHOPAEDIC & SPORTS MEDICINE CENTER
Entity Type:Organization
Organization Name:RANKIN ORTHOPAEDIC & SPORTS MEDICINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-526-7031
Mailing Address - Street 1:1160 VARNUM ST NE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2107
Mailing Address - Country:US
Mailing Address - Phone:202-526-7031
Mailing Address - Fax:202-529-8711
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:SUITE 312
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:202-526-7031
Practice Address - Fax:202-529-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01277Medicare ID - Type Unspecified