Kelly Randall Md Inc

LBN: Kelly Randall Md Inc
Kelly Randall Md Inc is an health care organization with primary practice located at 605 3Rd Ave Suite F, Fremont OH 43420-3269. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Kelly Randall Md Inc can be contacted via phone (419) 332-7311, or through Randall, Kelly via phone (419) 332-7311.

Contact Information

Primary practice address
605 3Rd Ave Suite F Fremont OH 43420-3269
Phone: (419) 332-7311
Fax: (419) 332-8552
Website:
Map and Directions
Authorized official contact:
Name: Randall, Kelly Doctor of Medicine (MD)
Phone: (419) 332-7311

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 35-04-5927-R Ohio

Profile Details

NPI number 1831401298
LBN Legal business name Kelly Randall Md Inc
DBA Doing business as
Authorized official Randall, Kelly Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 13th, 2010
Last updated Mar 21st, 2013 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831401298 NPPES
Ohio MEDICAID 0491052
Ohio Other 200001447
Ohio Other 000000350042

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