Provider Demographics
NPI:1215991963
Name:RINK, JOANNE DOROTHY (MD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:DOROTHY
Last Name:RINK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 E SPRUCE ST
Mailing Address - Street 2:SUITE 2A SURGICAL
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5614
Mailing Address - Country:US
Mailing Address - Phone:620-275-3741
Mailing Address - Fax:620-275-3761
Practice Address - Street 1:311 E SPRUCE ST
Practice Address - Street 2:SUITE 2A SURGICAL
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5614
Practice Address - Country:US
Practice Address - Phone:620-275-3741
Practice Address - Fax:620-275-3761
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0429596208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100419890CMedicaid
KS100419890CMedicaid
H59765Medicare UPIN
KSKA1610017Medicare PIN
KS104469Medicare PIN