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Organization

MY PRIVATE MD PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMAS PRATHER RANKIN M.D. (PRESIDENT)
(502) 253-6582
Entity
Organization

Contact information

Practice address
175 S ENGLISH STATION RD, LOUISVILLE, KY 40245-4160
(502) 253-6582
(502) 253-6585
Mailing address
175 S ENGLISH STATION RD, LOUISVILLE, KY 40245-4160
(502) 253-6582
(502) 253-6585

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19902
MH

Other

Enumeration date
08/07/2007
Last updated
08/07/2007
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