Northrup, John Randall

Northrup, John Randall is an individual health care provider with primary practice located at 1690 Us Highway 1 S Ste C , St Augustine FL 32084-6024. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Northrup, John Randall can be contacted via phone (904) 436-8001.

Contact Information

Primary practice address
1690 Us Highway 1 S Ste C St Augustine FL 32084-6024
Phone: (904) 436-8001
Fax: (904) 377-6776
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO3952 Florida
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO3952 Florida

Profile Details

NPI number 1891178406
LBN Legal business name Northrup, John Randall
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2015
Last updated Oct 31st, 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 1891178406 NPPES
Florida MEDICAID 101521600

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