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General NPI Number Information
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NPI Number | 1477553071
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Entity Type | Individual
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Provider Name | RANDALL D BEHRMANN D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 4301 WILSON ST
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City | FORT SILL
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State | OK
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Zip | 73503-4472
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Country | US
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Telephone | 580-558-2780
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 WILSON ST
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City | FORT SILL
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State | OK
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Zip | 73503-4472
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Country | US
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Telephone | 580-558-2780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 3801
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License Number State | OK
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