Provider Demographics
NPI:1225027865
Name:RANKIN, DAVID MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:RANKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BLOUNT AVE
Mailing Address - Street 2:SUITE 740
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920
Mailing Address - Country:US
Mailing Address - Phone:865-632-5885
Mailing Address - Fax:865-632-5893
Practice Address - Street 1:200 BLOUNT AVE
Practice Address - Street 2:STE 101
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-632-5885
Practice Address - Fax:865-632-5893
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD11391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4119664OtherBLUE CROSS
TN3188251Medicaid
TNTN0107OtherJOHN DEERE
TN3188251Medicaid
TN3188251Medicaid
TN204124194OtherTAX ID NUMBER