Page, Randell L

Page, Randell L is an individual health care provider with primary practice located at 215 E Hawaii Ave , Nampa ID 83686-6011. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Page, Randell L can be contacted via phone (208) 463-3234.

Contact Information

Primary practice address
215 E Hawaii Ave Nampa ID 83686-6011
Phone: (208) 463-3234
Fax: (208) 463-3044
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 088 Idaho

Profile Details

NPI number 1750370771
LBN Legal business name Page, Randell L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Dec 18th, 2013 - about 13 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 1750370771 NPPES
Idaho Other S0883 BLUE CROSS
Idaho MEDICAID 002365800 BLUE CROSS
Idaho Other 110057530 BLUE CROSS
Idaho Other 000010006056 BLUE CROSS

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