Provider Demographics
NPI:1790783041
Name:RANSON, NICHOLAS TODD (M D)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:TODD
Last Name:RANSON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:929 BUSINESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-8683
Mailing Address - Country:US
Mailing Address - Phone:231-594-7062
Mailing Address - Fax:231-594-7886
Practice Address - Street 1:929 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-8683
Practice Address - Country:US
Practice Address - Phone:231-947-6246
Practice Address - Fax:231-947-8864
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024004550207W00000X, 207WX0200X
WAMD00042059207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806847202OtherPUBLIC ASSISTANCE
WA0182076OtherLABOR AND INDUSTRIES
WA8384828Medicaid
WAS 9296RAOtherASURIS (REGENCE NW HEALTH
WAWA 0690OtherNORTHWEST BENEFIT NETWORK
IDKW906OtherBLUE CROSS OF IDAHO
WAP00108507OtherRAILROAD MEDICARE
WAA034OtherTRICARE
ID000010147398OtherASURIS (REGENCE BS OF ID)
ID000010147398OtherASURIS (REGENCE BS OF ID)
IDKW906OtherBLUE CROSS OF IDAHO
ID806847202OtherPUBLIC ASSISTANCE