Provider Demographics
NPI:1780883728
Name:RANKIN, MICHAEL D (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:RANKIN
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:PO BOX 188
Mailing Address - Street 2:BLYTHEWOOD
Mailing Address - City:HARRODSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40330-0188
Mailing Address - Country:US
Mailing Address - Phone:404-806-5440
Mailing Address - Fax:
Practice Address - Street 1:188 HARRODSBURG RD
Practice Address - Street 2:BLYTHEWOOD
Practice Address - City:HARRODSBURG
Practice Address - State:KY
Practice Address - Zip Code:40330-0188
Practice Address - Country:US
Practice Address - Phone:404-806-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C67784Medicare UPIN