Thornton, Randolph E

Thornton, Randolph E is an individual health care provider with primary practice located at 2606 Park St , Jacksonville FL 32204-4520. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Thornton, Randolph E can be contacted via phone (904) 388-4646.

Contact Information

Primary practice address
2606 Park St Jacksonville FL 32204-4520
Phone: (904) 388-4646
Fax: (904) 388-9017
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME0048083 Florida

Profile Details

NPI number 1750352647
LBN Legal business name Thornton, Randolph E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Mar 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750352647 NPPES
Florida MEDICAID 0645079-01

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