Anderson, Randal Carl
Anderson, Randal Carl is an individual health care provider with primary practice located at 510 E Stoner Ave , Shreveport LA 71101-4243. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Anderson, Randal Carl can be contacted via phone (318) 990-5322.Contact Information
Primary practice address
510 E Stoner Ave
Shreveport LA 71101-4243
Phone: (318) 990-5322
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | M-9167 | Idaho |
Profile Details
| NPI number | 1851342182 |
|---|---|
| LBN Legal business name | Anderson, Randal Carl |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Mar 1st, 2024 - about 2 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 | 1851342182 | NPPES |
| Arkansas | Other | P00428982 | RAILROAD MEDICARE |
| Arkansas | MEDICAID | 165862001 | RAILROAD MEDICARE |
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