Brandt, Randall Scott

Brandt, Randall Scott is an individual health care provider with primary practice located at 1040 Division St , Mauston WI 53948-1931. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Brandt, Randall Scott can be contacted via phone (608) 847-5000.

Contact Information

Primary practice address
1040 Division St Mauston WI 53948-1931
Phone: (608) 847-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 844 Wisconsin

Profile Details

NPI number 1710978754
LBN Legal business name Brandt, Randall Scott
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2005
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710978754 NPPES
Wisconsin MEDICAID 42957900

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