Provider Demographics
NPI:1679695910
Name:RANK, DOUGLAS H (MD)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:H
Last Name:RANK
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 1:12 W PIKE ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011
Mailing Address - Country:US
Mailing Address - Phone:859-426-5951
Mailing Address - Fax:859-426-1320
Practice Address - Street 1:12 W PIKE ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011
Practice Address - Country:US
Practice Address - Phone:859-426-5951
Practice Address - Fax:859-426-1320
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27590207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1679695910OtherNPI
KY2084P0800XOtherTAXONOMY
KY64275902Medicaid
E67783Medicare UPIN
KY64275902Medicaid