Provider Demographics
NPI:1275879876
Name:APRIL L. RANDLE MD INC
Entity Type:Organization
Organization Name:APRIL L. RANDLE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RANDLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-564-9222
Mailing Address - Street 1:PO BOX 970
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-0970
Mailing Address - Country:US
Mailing Address - Phone:970-564-9222
Mailing Address - Fax:970-564-5857
Practice Address - Street 1:215 LINDEN ST
Practice Address - Street 2:SUITE D
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321
Practice Address - Country:US
Practice Address - Phone:970-564-9222
Practice Address - Fax:970-564-5857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO37500082Medicaid
AZH89742Medicare UPIN
COH89742Medicare UPIN