Kimball, Randall Mark

Kimball, Randall Mark is an individual health care provider with primary practice located at 1 West Ave Suite 125, Saratoga Springs NY 12866-6045. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Kimball, Randall Mark can be contacted via phone (518) 693-4418.

Contact Information

Primary practice address
1 West Ave Suite 125 Saratoga Springs NY 12866-6045
Phone: (518) 693-4418
Fax: (518) 693-4481
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 271859 New York

Profile Details

NPI number 1972763977
LBN Legal business name Kimball, Randall Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2008
Last updated Jun 6th, 2014 - about 12 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 1972763977 NPPES
New York MEDICAID 03649552

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