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
Phone: (208) 884-3376
Fax: (208) 884-0858
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740217603 | NPPES |
| Idaho | MEDICAID | 003412200 |
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