Provider Demographics
NPI:1073512711
Name:ESTEP, RANDEL DEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:RANDEL
Middle Name:DEAN
Last Name:ESTEP
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:9600 BROADWAY EXT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-7408
Mailing Address - Country:US
Mailing Address - Phone:405-230-9000
Mailing Address - Fax:405-230-9175
Practice Address - Street 1:4901 W RENO AVE
Practice Address - Street 2:STE 500
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-6346
Practice Address - Country:US
Practice Address - Phone:405-230-9250
Practice Address - Fax:405-943-0742
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2021-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK007579602083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H79161Medicare UPIN