Provider Demographics
NPI:1851364178
Name:MONA RANE, MD CHARTERED
Entity Type:Organization
Organization Name:MONA RANE, MD CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONA
Authorized Official - Middle Name:
Authorized Official - Last Name:RANE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-624-8500
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
Practice Address - Country:US
Practice Address - Phone:620-624-8500
Practice Address - Fax:620-624-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04298122086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS102437OtherBLUE CROSS BLUE SHIELD
KS102437OtherBLUE CROSS BLUE SHIELD
KS102437Medicare ID - Type Unspecified