Individual
MR. RANDALL DAVID LEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 ALICE PECK DAY DR, LEBANON, NH 03766-2904
(603) 442-5630
(603) 442-5631
Mailing address
10 ALICE PECK DAY DR, LEBANON, NH 03766-2900
(603) 448-3121
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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