Doctor Name: | DR. KENNY RATANA |
NPI Number: | 1124014030 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | R2H16 |
Business Practice Address: | 527 Benham St # B Bonne Terre, MO - 636281205 |
Business Phone Number: | 5733583833 |
Business Fax Number: | |
Mailing Address: | 121 Westmount Dr Apt 84, FARMINGTON |
State: | MO |
Postal Code: | 636403502 |
Phone Number: | 5733583833 |
Fax Number: | |
NPI Enumeration Date: | 09/26/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | R2H16 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |