Randle, Jeffrey G

Randle, Jeffrey G is an individual health care provider with primary practice located at 1160 E 3900 S #5000, Salt Lake City UT 84124-1275. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Randle, Jeffrey G can be contacted via phone (801) 262-8486.

Contact Information

Primary practice address
1160 E 3900 S #5000 Salt Lake City UT 84124-1275
Phone: (801) 262-8486
Fax: (801) 284-8699
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 2944031205 Utah

Profile Details

NPI number 1063404424
LBN Legal business name Randle, Jeffrey G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Aug 24th, 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 1063404424 NPPES
Utah MEDICAID D1019

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