Randall, Kyle Robert
Randall, Kyle Robert is an sole proprietor health care provider with primary practice located at 2911 Knapp St Ne Suite A, Grand Rapids MI 49525. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Randall, Kyle Robert can be contacted via phone (616) 451-9925.Contact Information
Primary practice address
2911 Knapp St Ne Suite A
Grand Rapids MI 49525
Phone: (616) 451-9925
Fax: (616) 328-5380
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 4301061642 | Michigan |
Profile Details
| NPI number | 1154396364 |
|---|---|
| LBN Legal business name | Randall, Kyle Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 21st, 2006 |
| Last updated | Nov 21st, 2014 - about 10 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 | 1154396364 | NPPES |
| Michigan | MEDICAID | 4334872-10 |
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