Basic Information
Provider Information
NPI: 1710186077
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RANKIN
FirstName: JOY
MiddleName: DALYN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 417
Address2: 365 GENEVA ROAD
City: BUENA VISTA
State: GA
PostalCode: 318030417
CountryCode: US
TelephoneNumber: 2296492171
FaxNumber: 2296492524
Practice Location
Address1: 400 N STATE OF FRANKLIN RD
Address2:  
City: JOHNSON CITY
State: TN
PostalCode: 376046035
CountryCode: US
TelephoneNumber: 4234316111
FaxNumber: 4234312910
Other Information
ProviderEnumerationDate: 07/16/2007
LastUpdateDate: 05/13/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000X71274GAN Allopathic & Osteopathic PhysiciansGeneral Practice 
207P00000X58515TNY Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X0101266065VAN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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