Ellsworth, Randal N

Ellsworth, Randal N is an individual health care provider with primary practice located at 1735 N State St , Provo UT 84604-1010. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Ellsworth, Randal N can be contacted via phone (801) 374-1818.

Contact Information

Primary practice address
1735 N State St Provo UT 84604-1010
Fax: (801) 379-2959
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 942742051205 Utah

Profile Details

NPI number 1588635627
LBN Legal business name Ellsworth, Randal N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Jul 8th, 2007 - about 17 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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