Provider Demographics
NPI:1689687816
Name:RANKA, PRAKASH M (MD)
Entity type:Individual
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First Name:PRAKASH
Middle Name:M
Last Name:RANKA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2420 W PIERCE ST
Mailing Address - Street 2:STE 200B
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3543
Mailing Address - Country:US
Mailing Address - Phone:575-628-0926
Mailing Address - Fax:575-628-0493
Practice Address - Street 1:5419 N LOVINGTON HWY
Practice Address - Street 2:COMPLEX 5, SUITE 1
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-9131
Practice Address - Country:US
Practice Address - Phone:505-433-4000
Practice Address - Fax:505-392-7965
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2008-03-25
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Provider Licenses
StateLicense IDTaxonomies
NM81-293207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM002B03OtherBCBS
NM00004465Medicaid
NM00004465Medicaid