Clark, Randall

Clark, Randall is an individual health care provider with primary practice located at 13123 E 16Th Ave , Aurora CO 80045-7106. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pediatric Anesthesiology. Allopathic & Osteopathic Physicians / Pediatric Anesthesiology is his primary health care specialty. Clark, Randall can be contacted via phone (720) 777-1234.

Contact Information

Primary practice address
13123 E 16Th Ave Aurora CO 80045-7106
Phone: (720) 777-1234
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 27933 Colorado
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X DR.0027933 Colorado

Profile Details

NPI number 1447200944
LBN Legal business name Clark, Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Nov 2nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447200944 NPPES
Colorado MEDICAID 01279330

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