Healthcare Provider Details
I. General information
NPI: 1033157276
Provider Name (Legal Business Name): RANDY NEAL WEBB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/02/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
802 2ND ST SE
CUT BANK MT
59427-3329
US
IV. Provider business mailing address
802 2ND ST SE
CUT BANK MT
59427-3329
US
V. Phone/Fax
- Phone: 406-873-2251
- Fax: 406-873-3118
- Phone: 406-873-2251
- Fax: 406-873-3118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 7878 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: