Stahly, Randall L

Stahly, Randall L is an individual health care provider with primary practice located at 3004 Gordonville Rd , Cape Girardeau MO 63703-5008. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Stahly, Randall L can be contacted via phone (573) 332-1972.

Contact Information

Primary practice address
3004 Gordonville Rd Cape Girardeau MO 63703-5008
Fax: (573) 334-4667
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X R6455 Missouri

Profile Details

NPI number 1649320532
LBN Legal business name Stahly, Randall L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Feb 26th, 2021 - about 3 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 1649320532 NPPES
Missouri MEDICAID 240926832

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