Benedict, Randall L
Benedict, Randall L is an individual health care provider with primary practice located at 809 N Liberty St , Boise ID 83704-8703. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Benedict, Randall L can be contacted via phone (208) 327-0627.Contact Information
Primary practice address
809 N Liberty St
Boise ID 83704-8703
Phone: (208) 327-0627
Fax: (208) 376-5258
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | P133 | Idaho |
Profile Details
| NPI number | 1942239264 |
|---|---|
| LBN Legal business name | Benedict, Randall L |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 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 | 1942239264 | NPPES |
| Idaho | MEDICAID | 001970800 |
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