Provider Demographics
NPI:1174248967
Name:ST. JOHN ASCENSION
Entity type:Organization
Organization Name:ST. JOHN ASCENSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:RANNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-748-7878
Mailing Address - Street 1:1919 S WHEELING AVE STE 606
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5635
Mailing Address - Country:US
Mailing Address - Phone:918-748-7878
Mailing Address - Fax:
Practice Address - Street 1:1919 S WHEELING AVE STE 606
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5635
Practice Address - Country:US
Practice Address - Phone:918-748-7878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric SurgeryGroup - Single Specialty