Provider Demographics
NPI:1619942828
Name:RANNEY, TIMOTHY DALE (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DALE
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 1:7261 MERCY ROAD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68180-0001
Mailing Address - Country:US
Mailing Address - Phone:402-390-1898
Mailing Address - Fax:402-392-4142
Practice Address - Street 1:7261 MERCY ROAD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68180-0001
Practice Address - Country:US
Practice Address - Phone:402-390-1898
Practice Address - Fax:402-392-4142
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17215207Q00000X
IA26424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine