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General NPI Number Information
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NPI Number | 1679567325
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Entity Type | Individual
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Provider Name | RANDALL V LESTER MD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 510 CHERRY ST SUITE 206, BLDG A
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City | BLUEFIELD
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State | WV
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Zip | 24701-3338
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Country | US
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Telephone | 304-327-1888
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Fax | 304-327-1889
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Provider Business Mailing Address
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Address Line | 510 CHERRY ST. SUITE 206, BLDG A
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City | BLUEFIELD
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State | WV
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Zip | 24701
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Country | US
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Telephone | 304-327-1888
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Fax | 304-327-1889
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0101057487
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 01066693A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 12612
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License Number State | WV
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