Cousins, Randall Jon

Cousins, Randall Jon is an individual health care provider with primary practice located at 2000 Plymouth Rd Suite 100, Minnetonka MN 55305-2366. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Cousins, Randall Jon can be contacted via phone (763) 581-5250.

Contact Information

Primary practice address
2000 Plymouth Rd Suite 100 Minnetonka MN 55305-2366
Phone: (763) 581-5250
Fax: (763) 581-5257
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 27678 Minnesota

Profile Details

NPI number 1962486712
LBN Legal business name Cousins, Randall Jon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Sep 2nd, 2013 - about 11 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 1962486712 NPPES
Minnesota MEDICAID 631570400

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