Burr, Randall D

Burr, Randall D is an individual health care provider with primary practice located at 1618 S. Millennium Way Suite 100, Meridian ID 83642-6457. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Burr, Randall D can be contacted via phone (208) 884-3376.

Contact Information

Primary practice address
1618 S. Millennium Way Suite 100 Meridian ID 83642-6457
Fax: (208) 884-0858
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X M5986 Idaho

Profile Details

NPI number 1740217603
LBN Legal business name Burr, Randall D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Aug 29th, 2019 - about 5 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 1740217603 NPPES
Idaho MEDICAID 003412200

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