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 / Neurology, Allopathic & Osteopathic Physicians / Vascular Neurology. Allopathic & Osteopathic Physicians / Vascular 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:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036145444 Illinois
Allopathic & Osteopathic Physicians / Vascular Neurology 2084V0102X 2007015340 Missouri
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 Jul 27th, 2023 - about 3 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 1912097817 NPPES
Missouri MEDICAID 205461205

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