Provider Demographics
NPI:1952302416
Name:RANKIN, DAVID KEENAN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KEENAN
Last Name:RANKIN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:440 W JUBAL EARLY DR
Mailing Address - Street 2:#120
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-723-9889
Mailing Address - Fax:540-723-9809
Practice Address - Street 1:440 W JUBAL EARLY DR
Practice Address - Street 2:#120
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-723-9889
Practice Address - Fax:540-723-9809
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2010-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102037125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA56-3564-1Medicaid
VA272773OtherANTHEM
WV5630235000Medicaid
F19855Medicare UPIN
WV5630235000Medicaid