Individual
RANDY W EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2315 E HARMONY RD, STE 140, FORT COLLINS, CO 80528
(970) 484-6700
(970) 484-5723
Mailing address
2301 HOUSE AVE, STE 502, CHEYENNE, WY 82001-3179
(307) 635-4131
(307) 635-6570
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
114117
MT
208800000X
Urology Physician
30088
CO
208800000X
Urology Physician
35652
OK
208800000X
Urology Physician
Primary
9048A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01300888
—
CO
Enumeration date
05/26/2006
Last updated
02/14/2023
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