Lippincott, Randall L

Lippincott, Randall L is an individual health care provider with primary practice located at 5779 E Mayo Blvd , Phoenix AZ 85054-4502. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Lippincott, Randall L can be contacted via phone (480) 301-8000.

Contact Information

Primary practice address
5779 E Mayo Blvd Phoenix AZ 85054-4502
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 1568 Arizona

Profile Details

NPI number 1245212661
LBN Legal business name Lippincott, Randall L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2005
Last updated Oct 30th, 2007 - about 19 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 1245212661 NPPES
Arizona Other 86080015085259A246 TRIWEST
Arizona MEDICAID 342915 TRIWEST

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