Randle, Jeffrey G
Randle, Jeffrey G is an individual health care provider with primary practice located at 1160 E 3900 S #5000, Salt Lake City UT 84124-1275. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Randle, Jeffrey G can be contacted via phone (801) 262-8486.Contact Information
Primary practice address
1160 E 3900 S #5000
Salt Lake City UT 84124-1275
Phone: (801) 262-8486
Fax: (801) 284-8699
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 2944031205 | Utah |
Profile Details
NPI number | 1063404424 |
---|---|
LBN Legal business name | Randle, Jeffrey G |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 22nd, 2005 |
Last updated | Aug 24th, 2023 - about last year |
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 | 1063404424 | NPPES |
Utah | MEDICAID | D1019 |
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