Provider Demographics
NPI:1538729371
Name:RANKIN, JUSTIN LEVI (DO)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:LEVI
Last Name:RANKIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 S YALE AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3326
Mailing Address - Country:US
Mailing Address - Phone:918-481-4012
Mailing Address - Fax:918-481-4063
Practice Address - Street 1:6655 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3326
Practice Address - Country:US
Practice Address - Phone:918-481-4012
Practice Address - Fax:918-481-4063
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51510136512084P0800X
OK79812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry