Basic Information
| Provider Information | |||||||||
| NPI: | 1821165861 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RANEY | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 823 SW MULVANE - LOWER LEVEL | ||||||||
| Address2: | PHYSICIAN SUPPORT SERVICES | ||||||||
| City: | TOPKEA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666061764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7853546626 | ||||||||
| FaxNumber: | 7853546305 | ||||||||
| Practice Location | |||||||||
| Address1: | 4505 NW FIELDING RD | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666182651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852700080 | ||||||||
| FaxNumber: | 7852700002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 05/20/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0434815 | KS | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200726330A | 05 | KS | MEDICAID | 068002114 | 01 | KS | MEDICARE PTAN | OTHER |