Provider Demographics
NPI:1285643858
Name:EARICK, RANDALL NEY (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:NEY
Last Name:EARICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10820 OAKMONT DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3371
Mailing Address - Country:US
Mailing Address - Phone:623-974-5588
Mailing Address - Fax:623-974-5589
Practice Address - Street 1:10820 OAKMONT DR
Practice Address - Street 2:SUITE 3
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3371
Practice Address - Country:US
Practice Address - Phone:623-974-5588
Practice Address - Fax:623-974-5589
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0944620OtherBCBS
AZAZ0944620OtherBCBS