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
Fax: (219) 738-6714
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659368017 NPPES
Indiana MEDICAID 200005040

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