Swackhammer, Randy L
Swackhammer, Randy L is an sole proprietor health care provider with primary practice located at 2400 Wayne Memorial Dr Ste C , Goldsboro NC 27534-1750. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Swackhammer, Randy L can be contacted via phone (919) 988-9674.Contact Information
Primary practice address
2400 Wayne Memorial Dr Ste C
Goldsboro NC 27534-1750
Phone: (919) 988-9674
Fax: (919) 988-9676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 33315 | North Carolina |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 33315 | North Carolina |
Profile Details
| NPI number | 1770607228 |
|---|---|
| LBN Legal business name | Swackhammer, Randy L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Jan 18th, 2017 - about 9 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 | 1770607228 | NPPES |
| North Carolina | Other | P01133879 | RAILROAD MEDICARE PTAN |
| North Carolina | MEDICAID | 0012769800001 | RAILROAD MEDICARE PTAN |
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