Smith, Randy Brooks

Smith, Randy Brooks is an individual health care provider with primary practice located at Rt 1 Box 56 Suite 1, Ripley WV 25271. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Smith, Randy Brooks can be contacted via phone (304) 372-8577.

Contact Information

Primary practice address
Rt 1 Box 56 Suite 1 Ripley WV 25271
Fax: (304) 372-9669
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1922 West Virginia

Profile Details

NPI number 1083736714
LBN Legal business name Smith, Randy Brooks
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2007
Last updated Jul 8th, 2007 - about 19 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 1083736714 NPPES
West Virginia MEDICAID 0136004000

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