Edgell, Randall C
Edgell, Randall C is an individual health care provider with primary practice located at 1225 S Grand Blvd , Saint Louis MO 63104-1016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Neurology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Edgell, Randall C can be contacted via phone (314) 977-4864.Contact Information
Primary practice address
1225 S Grand Blvd
Saint Louis MO 63104-1016
Phone: (314) 977-4864
Fax: (314) 977-4878
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Neurology | 2084V0102X | 2007015340 | Missouri |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036145444 | Illinois |
| Allopathic & Osteopathic Physicians / Vascular Neurology | 2084V0102X | 036145444 | Illinois |
Profile Details
| NPI number | 1912097817 |
|---|---|
| LBN Legal business name | Edgell, Randall C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2006 |
| Last updated | Jun 29th, 2026 - about 4 months 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 | 1912097817 | NPPES |
| Missouri | MEDICAID | 205461205 |
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