RANCE BALLARD WILBOURN MD NPI 1063676690

NPI Information

NPI: 1063676690
Provider Name: RANCE BALLARD WILBOURN, MD
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
2215 WEST ST STE 100
GERMANTOWN, TN
ZIP 38138
Phone: (901) 440-8482
Get Directions

Rance Ballard Wilbourn, MD is a neurology psychiatry neurology in Germantown, TN with 19 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Rance Ballard Wilbourn, MD NPI is 1063676690. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduation Year:2005

The provider's business location address is:

2215 WEST ST STE 100
GERMANTOWN, TN
ZIP 38138
Phone: (901) 440-8482
Fax: (901) 440-8582

The NPI 1063676690 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2008 and was last updated on 4/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	20766	MISSISSIPPI	No
2	2084N0400X	Psychiatry & Neurology	Neurology	IP958	KENTUCKY	No
3	2084N0400X	Psychiatry & Neurology	Neurology	56737	TENNESSEE	No
4	2084N0400X	Psychiatry & Neurology	Neurology	51679	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	230387001	MEDICAID	ARKANSAS
2	Q063676690	MEDICAID	TENNESSEE
3	04520877	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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