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Kelly Randall Md Inc
Specialist in Fremont, Ohio
NPI 1831401298

Kelly Randall Md Inc is a Specialist based in Fremont, OH. Kelly Randall Md Inc practices in Fremont, OH. The NPI Number for Kelly Randall Md Inc is 1831401298 and holds a License No. 35-04-5927-R (Ohio).

The current practice location address for Kelly Randall Md Inc is 605 3Rd Ave, Fremont, OH and can be reached out via phone at 419-332-7311 and via fax at 419-332-8552.

Location: 605 3Rd Ave, Fremont, OH, 43420-3269
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1831401298
Provider Name
Kelly Randall Md Inc
Credential
Provider Entity Type
Organization
Address
605 3Rd Ave, Fremont, OH, 43420-3269
Phone Number
419-332-7311
Fax Number
419-332-8552
Provider Enumeration Date
07/13/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0491052 05 OH
200001447 01 OH RAILROAD MEDICARE
000000350042 01 OH ANTHEM CMIC
institution
Provider Business Practice Location Address Details
Address
605 3Rd Ave
City
Fremont
State
Ohio
Zip
43420-3269
Phone Number
419-332-7311
Fax Number
419-332-8552
person
Provider Business Mailing Address Details
Address
605 3Rd Ave
City
Fremont
State
Ohio
Zip
43420-3269
Phone Number
419-332-7311
Fax Number
419-332-8552
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
35-04-5927-R (Ohio)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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