Individual
RANDAL FORD JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 THREE SPRINGS BLVD, DURANGO, CO 81301-8296
(970) 764-2100
Mailing address
PO BOX 5471, DENVER, CO 80217-5471
(866) 898-7136
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23756
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76738787
—
CO
05
—
K5532
—
NM
Enumeration date
07/16/2006
Last updated
05/21/2008
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