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
Phone: (479) 725-3813
Fax: (479) 419-4046
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1275737116 | NPPES |
Arkansas | MEDICAID | 181106719 |
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