Randall, Kyle

Randall, Kyle is an individual health care provider with primary practice located at 715 Richland Mall , Ontario OH 44906-3802. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Randall, Kyle can be contacted via phone (419) 709-8645.

Contact Information

Primary practice address
715 Richland Mall Ontario OH 44906-3802
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 35.124114 Ohio

Profile Details

NPI number 1750554218
LBN Legal business name Randall, Kyle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2008
Last updated Jan 25th, 2021 - about 4 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 1750554218 NPPES
Ohio MEDICAID 2197144

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