Individual
MR. RANDALL DAVID LEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
LA015413
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021450
—
VT
05
—
1346420
—
LA
05
—
3095403
—
NH
Enumeration date
05/05/2006
Last updated
09/08/2017
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