Slickers, Randall J

Slickers, Randall J is an individual health care provider with primary practice located at 550 Polk St Suite B, Twin Falls ID 83301-3916. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Slickers, Randall J can be contacted via phone (208) 814-9040.

Contact Information

Primary practice address
550 Polk St Suite B Twin Falls ID 83301-3916
Phone: (208) 814-9040
Fax: (208) 734-3675
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M3172 Idaho

Profile Details

NPI number 1932144748
LBN Legal business name Slickers, Randall J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Sep 6th, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932144748 NPPES
Idaho MEDICAID 003957900
Idaho Other P00431075

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