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Organization

JOE HUNDLEY RANKIN MD A PROF MEDICAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOE RANKIN MD (OWNER)
(660) 826-5960
Entity
Organization

Contact information

Practice address
1020 W FERTITTA BLVD, LEESVILLE, LA 71446-4645
(660) 826-5960
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2111701
LA
01
DT3261
RR MEDICARE
LA
Enumeration date
04/19/2007
Last updated
02/24/2020
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