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NPI Code Detail

MEDICARE: RANDY D SORUM M.D.

MEDICARE: RANDY D SORUM 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
12085R0001XRadiation Oncology PhysicianMD00034810WA
22085R0001XRadiation Oncology PhysicianMD-49706IA

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 : 1720059181
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY D SORUM M.D.
Provider Business Mailing Address
First Line : 230 NEBRASKA ST
Second Line :
City : SIOUX CITY
State : IA
Zip : 51101-1733
Country : US
Telephone Number : 712-252-9372
Fax Number : 712-252-9327
Provider Business Practice Location Address
First Line : 230 NEBRASKA ST
Second Line :
City : SIOUX CITY
State : IA
Zip : 51101-1733
Country : US
Telephone Number : 712-252-9372
Fax Number : 712-252-9327
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 11/08/2024

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Directions to “ RANDY D SORUM M.D.” Practice Location

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