Carson, Randall L
Carson, Randall L is an individual health care provider with primary practice located at 8600 S 36Th Ter , Fort Smith AR 72908-8768. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Carson, Randall L can be contacted via phone (479) 709-7465.Contact Information
Primary practice address
8600 S 36Th Ter
Fort Smith AR 72908-8768
Phone: (479) 709-7465
Fax: (479) 709-7466
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | C6040 | Arkansas |
Profile Details
| NPI number | 1669469508 |
|---|---|
| LBN Legal business name | Carson, Randall L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2005 |
| Last updated | Aug 23rd, 2010 - about 14 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 | 1669469508 | NPPES |
| Arkansas | MEDICAID | 105898001 | |
| Arkansas | MEDICAID | 100071780A |
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