Bundy, Randall Earl

Bundy, Randall Earl is an sole proprietor health care provider with primary practice located at 1407 S State St , New Ulm MN 56073. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Bundy, Randall Earl can be contacted via phone (507) 354-3181.

Contact Information

Primary practice address
1407 S State St New Ulm MN 56073
Phone: (507) 354-3181
Fax: (507) 354-3183
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP1021 Minnesota

Profile Details

NPI number 1982627535
LBN Legal business name Bundy, Randall Earl
Credentials LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 25th, 2006
Last updated Jun 30th, 2018 - about 6 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 1982627535 NPPES
Minnesota Other 122361 UCARE
Minnesota Other 150226 UCARE
Minnesota Other 8441161 UCARE
Minnesota MEDICAID 230222500 UCARE
Minnesota Other 45396BU UCARE
Minnesota Other 84722 UCARE

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