Individual
RANDY J IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
(317) 583-7600
Mailing address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
01052908A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000176480
BCBS PIN
—
05
—
200316790A
—
IN
01
—
770002539
RAILROAD MEDICARE PIN
—
Enumeration date
07/18/2006
Last updated
06/30/2022
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