Johnson, Randall Roy
Johnson, Randall Roy is an individual health care provider with primary practice located at 1305 W American Dr , Neenah WI 54956-1993. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Johnson, Randall Roy can be contacted via phone (920) 725-9373.Contact Information
Primary practice address
1305 W American Dr
Neenah WI 54956-1993
Phone: (920) 725-9373
Fax: (920) 720-7392
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 47081 | Wisconsin |
Profile Details
| NPI number | 1447293188 |
|---|---|
| LBN Legal business name | Johnson, Randall Roy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Aug 10th, 2022 - about 3 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 | 1447293188 | NPPES |
| Wisconsin | MEDICAID | 3455700 | |
| Wisconsin | Other | P00144769 |
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