Kjorstad, Randy J

Kjorstad, Randy J is an individual health care provider with primary practice located at 1245 Nw 4Th St Ste 101 , Redmond OR 97756-1680. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Kjorstad, Randy J can be contacted via phone (541) 548-7761.

Contact Information

Primary practice address
1245 Nw 4Th St Ste 101 Redmond OR 97756-1680
Phone: (541) 548-7761
Fax: (541) 598-3485
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M-9325 Idaho
Allopathic & Osteopathic Physicians / Surgery 208600000X 12855 Montana
Allopathic & Osteopathic Physicians / Surgery 208600000X 9756A Wyoming

Profile Details

NPI number 1043283336
LBN Legal business name Kjorstad, Randy J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Nov 2nd, 2023 - about 2 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 1043283336 NPPES
Wyoming Other W26189 SJMC PTAN

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