Individual
THOMAS R. RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1275 N HIGH ST, HILLSBORO, OH 45133-8273
(937) 393-6140
Mailing address
968 WAYNOKA DR, LAKE WAYNOKA, OH 45171-9762
(937) 446-1639
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.073247
OH
207Q00000X
Family Medicine Physician
35-073247
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000344443
ANTHEM BCBS
OH
05
—
2418155
—
OH
01
—
P00190832
RAILROAD MEDICARE
—
Enumeration date
02/14/2006
Last updated
02/08/2024
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