Provider Demographics
NPI:1083220651
Name:HANGER, RANDALL NEAL SR
Entity Type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:NEAL
Last Name:HANGER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 MONTGOMERY RD NE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9769
Mailing Address - Country:US
Mailing Address - Phone:740-763-2488
Mailing Address - Fax:
Practice Address - Street 1:3420 MONTGOMERY RD NE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-9769
Practice Address - Country:US
Practice Address - Phone:740-763-2488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-19
Last Update Date:2020-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker