Randolph, Joseph Justis

Randolph, Joseph Justis is an individual health care provider with primary practice located at 1406 6Th Ave N , St Cloud MN 56303-1901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Randolph, Joseph Justis can be contacted via phone (320) 255-5657.

Contact Information

Primary practice address
1406 6Th Ave N St Cloud MN 56303-1901
Phone: (320) 255-5657
Fax: (320) 656-7194
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 42563 Minnesota
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X MD60181938 Washington

Profile Details

NPI number 1164497830
LBN Legal business name Randolph, Joseph Justis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Feb 17th, 2011 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1164497830 NPPES
Washington MEDICAID 1164497830

Popular Providers