Jernigan, Randal Ford

Jernigan, Randal Ford is an individual health care provider with primary practice located at 1010 Three Springs Blvd , Durango CO 81301-8296. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Jernigan, Randal Ford can be contacted via phone (970) 764-2100.

Contact Information

Primary practice address
1010 Three Springs Blvd Durango CO 81301-8296
Phone: (970) 764-2100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 23756 Colorado

Profile Details

NPI number 1063439917
LBN Legal business name Jernigan, Randal Ford
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated May 21st, 2008 - about 16 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 1063439917 NPPES
New Mexico MEDICAID K5532
New Mexico MEDICAID 76738787

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