Provider Demographics
NPI:1487838983
Name:RANKIN PLASTIC SURGERY CENTER
Entity type:Organization
Organization Name:RANKIN PLASTIC SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-817-2764
Mailing Address - Street 1:348 CROSSGATES BLVD
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-2700
Mailing Address - Country:US
Mailing Address - Phone:601-824-3977
Mailing Address - Fax:601-824-3979
Practice Address - Street 1:348 CROSSGATES BLVD
Practice Address - Street 2:SUITE 2400
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-2700
Practice Address - Country:US
Practice Address - Phone:601-824-3977
Practice Address - Fax:601-824-3979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty