Jennings, Randall W
Jennings, Randall W is an individual health care provider with primary practice located at 1900 Woodland Dr , Coos Bay OR 97420-2045. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Jennings, Randall W can be contacted via phone (541) 267-5151.Contact Information
Primary practice address
1900 Woodland Dr
Coos Bay OR 97420-2045
Phone: (541) 267-5151
Fax: (541) 266-4515
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 036105293 | Illinois |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 43003-020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | L09261R | Louisiana |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD166994 | Oregon |
Profile Details
| NPI number | 1467449827 |
|---|---|
| LBN Legal business name | Jennings, Randall W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Apr 27th, 2015 - about 9 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 | 1467449827 | NPPES |
| Oregon | MEDICAID | 500677744 | |
| Oregon | Other | R0000WFBTV | |
| Oregon | Other | 1407812365 | |
| Oregon | Other | 161133 | |
| Oregon | Other | P01434156 | |
| Oregon | Other | 005530345 |
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