Randolph, Joseph Brannon

Randolph, Joseph Brannon is an individual health care provider with primary practice located at 6801 Isaacs Orchard Rd Ste. 215, Springdale AR 72762-6545. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Randolph, Joseph Brannon can be contacted via phone (479) 725-3813.

Contact Information

Primary practice address
6801 Isaacs Orchard Rd Ste. 215 Springdale AR 72762-6545
Fax: (479) 419-4046
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X PO309038 Arkansas

Profile Details

NPI number 1275737116
LBN Legal business name Randolph, Joseph Brannon
Credentials MS, MBA, LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2007
Last updated Nov 25th, 2013 - about 12 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 1275737116 NPPES
Arkansas MEDICAID 181106719

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