Provider Demographics
NPI:1225011661
Name:HASSLER, RANDY DEE (MD)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:DEE
Last Name:HASSLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S SANTA FE AVE
Mailing Address - Street 2:STE 380
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4189
Mailing Address - Country:US
Mailing Address - Phone:785-827-9635
Mailing Address - Fax:785-827-6697
Practice Address - Street 1:501 S SANTA FE AVE
Practice Address - Street 2:STE 380
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4189
Practice Address - Country:US
Practice Address - Phone:785-827-9635
Practice Address - Fax:785-827-6697
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0417849208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100081570AMedicaid
B68247Medicare UPIN
000373Medicare ID - Type Unspecified