Provider Demographics
NPI:1598748055
Name:RANE, MONA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:A
Last Name:RANE
Suffix:
Gender:F
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:PO BOX 1197
Mailing Address - Street 2:
Mailing Address - City:LIBERAL
Mailing Address - State:KS
Mailing Address - Zip Code:67905-1197
Mailing Address - Country:US
Mailing Address - Phone:620-624-8500
Mailing Address - Fax:620-624-8510
Practice Address - Street 1:109 E. 11TH STREET
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2762
Practice Address - Country:US
Practice Address - Phone:620-624-8500
Practice Address - Fax:620-624-8510
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04298122086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS102437OtherBLUE CROSS BLUE SHIELD
KSH72022Medicare UPIN
KS102437Medicare ID - Type Unspecified