Phillips, Randall Joseph

Phillips, Randall Joseph is an individual health care provider with primary practice located at 7221 Engle Rd Ste 220 , Fort Wayne IN 46804-2233. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Phillips, Randall Joseph can be contacted via phone (260) 432-1568.

Contact Information

Primary practice address
7221 Engle Rd Ste 220 Fort Wayne IN 46804-2233
Phone: (260) 432-1568
Fax: (260) 432-4969
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01042709 Indiana

Profile Details

NPI number 1124099395
LBN Legal business name Phillips, Randall Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated May 24th, 2024 - about 7 months 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 1124099395 NPPES
Indiana MEDICAID 100389260
Indiana MEDICAID 1124099395
Indiana MEDICAID 2038280

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