Mack, Randall

Mack, Randall is an individual health care provider with primary practice located at 10 Kruger Road , Plains MT 59859. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mack, Randall can be contacted via phone (406) 826-4800.

Contact Information

Primary practice address
10 Kruger Road Plains MT 59859
Phone: (406) 826-4800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA60595202 Washington
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MED-PAC-LIC-190 Montana

Profile Details

NPI number 1346356359
LBN Legal business name Mack, Randall
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2006
Last updated Apr 29th, 2020 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1346356359 NPPES
Washington MEDICAID 1346356359
Washington Other P01684706

Popular Providers