Bass, Randall Dwight
Bass, Randall Dwight is an individual health care provider with primary practice located at 1990 Industrial Boulevard , Houma LA 70363-7055. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as his primary health care specialty. Bass, Randall Dwight can be contacted via phone (985) 868-9300.Contact Information
Primary practice address
1990 Industrial Boulevard
Houma LA 70363-7055
Phone: (985) 868-9300
Fax: (985) 851-0053
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | 14997R | Louisiana |
Profile Details
| NPI number | 1780616953 |
|---|---|
| LBN Legal business name | Bass, Randall Dwight |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1780616953 | NPPES |
| Louisiana | Other | P00116891 | RAILROAD MEDICARE |
| Louisiana | MEDICAID | 1157694 | RAILROAD MEDICARE |
| Louisiana | Other | 1900G5758Z | RAILROAD MEDICARE |
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