Randall, Greg C

Randall, Greg C is an individual health care provider with primary practice located at 17599 Kenwood Trl , Lakeville MN 55044-8330. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Randall, Greg C can be contacted via phone (952) 985-8600.

Contact Information

Primary practice address
17599 Kenwood Trl Lakeville MN 55044-8330
Phone: (952) 985-8600
Fax: (952) 985-8699
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 28794 Minnesota

Profile Details

NPI number 1255333662
LBN Legal business name Randall, Greg C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Mar 10th, 2021 - about 5 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 1255333662 NPPES
Minnesota MEDICAID 351278900

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