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NPI Code Detail

MEDICARE: AMBER LOUISE RANDALL M.D.

MEDICARE: AMBER LOUISE RANDALL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician34269AZ
2207XS0114XAdult Reconstructive Orthopaedic Surgery Physician34269AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063496255
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER LOUISE RANDALL M.D.
Provider Business Mailing Address
First Line : 18444 N 25TH AVE STE 310
Second Line :
City : PHOENIX
State : AZ
Zip : 85023-1266
Country : US
Telephone Number : 866-974-2673
Fax Number : 866-939-2673
Provider Business Practice Location Address
First Line : 1840 N JASPER DR STE 2
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-1634
Country : US
Telephone Number : 866-974-2673
Fax Number : 866-939-2673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 02/27/2026

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Directions to “ AMBER LOUISE RANDALL M.D.” Practice Location

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