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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