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1821550450

NPI Code Detail

MEDICARE: DR. ROBYN S RANDALL MD

MEDICARE: DR. ROBYN S RANDALL MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	DR.0064836	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	029346	OTHER	CO	KAISER COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1821550450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBYN S RANDALL MD

Provider Business Mailing Address
First Line	:	10350 E DAKOTA AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80247-1314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 E HARMONY RD STE 190
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-3430
Country	:	US
Telephone Number	:	303-338-4545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2019
Last Update Date	:	02/13/2024

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Directions to “ DR. ROBYN S RANDALL MD” Practice Location

Language	Start Address	Practice Location

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