Braddom, Randall L
Braddom, Randall L is an sole proprietor health care provider with primary practice located at 1093 Golden Grove Dr , The Villages FL 32162-4023. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Braddom, Randall L can be contacted via phone (908) 601-7036.Contact Information
Primary practice address
1093 Golden Grove Dr
The Villages FL 32162-4023
Phone: (908) 601-7036
Fax: (352) 561-4512
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 25MA02637400 | New Jersey |
Profile Details
NPI number | 1255302360 |
---|---|
LBN Legal business name | Braddom, Randall L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 27th, 2006 |
Last updated | Jun 3rd, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1255302360 | NPPES |
New Jersey | MEDICAID | 9074201 |
Popular Providers
-
Reilly, Thomas
1580 Santa Barbara Blvd , The Villages FL 32159-6827 -
Siegel, Cara B
3001 Edwards Mill Rd Suite 200, Raleigh NC 27612-5243 -
Thaxton, Lora Lee
1451 El Camino Real , The Villages FL 32159 -
Smith, Linda C
85 Ih 10 N Ste 202 , Beaumont TX 77707-2500 -
Cox, Rodde D
1000 N Curtis Rd , Boise ID 83706 -
Patterson, Dwayne E
7101 Creedmoor Rd Ste 109 , Raleigh NC 27613-1682 -
Syed, Asma A.
5808 Old Pasco Rd , Wesley Chapel FL 33544-4011 -
Weingarden, David Solomon
43555 Dalcoma Dr Ste 4, Clinton Township MI 48038-6310