Wilson, Randall Allen

Wilson, Randall Allen is an individual health care provider with primary practice located at 106 Commercial Dr , Harrodsburg KY 40330-1084. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Randall Allen can be contacted via phone (859) 734-3482.

Contact Information

Primary practice address
106 Commercial Dr Harrodsburg KY 40330-1084
Phone: (859) 734-3482
Fax: (859) 734-3432
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 33217 Kentucky

Profile Details

NPI number 1336121441
LBN Legal business name Wilson, Randall Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated May 4th, 2012 - about 13 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 1336121441 NPPES
Kentucky MEDICAID 64332174

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