Roberts, Randolph
Roberts, Randolph is an individual health care provider with primary practice located at 1201 S Main St , Crown Point IN 46307-8481. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Roberts, Randolph can be contacted via phone (219) 757-6320.Contact Information
Primary practice address
1201 S Main St
Crown Point IN 46307-8481
Phone: (219) 757-6320
Fax: (219) 738-6714
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 01036988 | Indiana |
Profile Details
| NPI number | 1659368017 |
|---|---|
| LBN Legal business name | Roberts, Randolph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Jan 25th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659368017 | NPPES |
| Indiana | MEDICAID | 200005040 |
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