1326341587 NPI number — RANDALL E CURRIER MD PC

Table of content: (NPI 1326341587)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326341587 NPI number — RANDALL E CURRIER MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RANDALL E CURRIER MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326341587
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1833 NEBRASKA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRANTS PASS
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97527-5701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-474-4503
Provider Business Mailing Address Fax Number:
541-474-4502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1833 NEBRASKA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRANTS PASS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97527-5701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-474-4503
Provider Business Practice Location Address Fax Number:
541-474-4502
Provider Enumeration Date:
12/09/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CURRIER
Authorized Official First Name:
RANDALL
Authorized Official Middle Name:
EUGENE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
541-474-4503

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD15574 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DQ9154 . This is a "MEDICARE/RAILROAD CARRIER" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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