Vannostrand, Willard Randolph

Vannostrand, Willard Randolph is an sole proprietor health care provider with primary practice located at 1260 S Campbell Ave Bldg 2 , Green Valley AZ 85614-0502. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Vannostrand, Willard Randolph can be contacted via phone (520) 407-5400.

Contact Information

Primary practice address
1260 S Campbell Ave Bldg 2 Green Valley AZ 85614-0502
Phone: (520) 407-5400
Fax: (520) 407-5990
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 7028 Arizona

Profile Details

NPI number 1922333772
LBN Legal business name Vannostrand, Willard Randolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2009
Last updated Aug 23rd, 2022 - 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 1922333772 NPPES
Arizona Other 01WCFBXA1 MEDICARE BILLING NO.

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