Provider Demographics
NPI:1770540916
Name:RANKINE, WILLIAM OLDEN JR (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:OLDEN
Last Name:RANKINE
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8909
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31095-8909
Mailing Address - Country:US
Mailing Address - Phone:478-953-1999
Mailing Address - Fax:478-953-0737
Practice Address - Street 1:116 TOMMY STALNAKER DR
Practice Address - Street 2:BLDG A
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-8983
Practice Address - Country:US
Practice Address - Phone:478-953-1999
Practice Address - Fax:478-953-0737
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA55294207P00000X
GA055294207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA934658OtherBCBS
GA701989215AMedicaid
GAP00336957OtherRAILROAD
GA701989215AMedicaid
GAI58291Medicare UPIN