Bundy, Randall Earl
Bundy, Randall Earl is an sole proprietor health care provider with primary practice located at 1407 S State St , New Ulm MN 56073. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Bundy, Randall Earl can be contacted via phone (507) 354-3181.Contact Information
Primary practice address
1407 S State St
New Ulm MN 56073
Phone: (507) 354-3181
Fax: (507) 354-3183
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP1021 | Minnesota |
Profile Details
| NPI number | 1982627535 |
|---|---|
| LBN Legal business name | Bundy, Randall Earl |
| Credentials | LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jun 30th, 2018 - about 8 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 | 1982627535 | NPPES |
| Minnesota | Other | 122361 | UCARE |
| Minnesota | Other | 150226 | UCARE |
| Minnesota | Other | 8441161 | UCARE |
| Minnesota | MEDICAID | 230222500 | UCARE |
| Minnesota | Other | 45396BU | UCARE |
| Minnesota | Other | 84722 | UCARE |
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