Provider Demographics
NPI:1407840556
Name:FINKEN, RANDALL L (MD)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:L
Last Name:FINKEN
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 1:3909 WOODLEY RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1169
Mailing Address - Country:US
Mailing Address - Phone:419-291-2670
Mailing Address - Fax:419-479-6999
Practice Address - Street 1:3909 WOODLEY RD
Practice Address - Street 2:SUITE 500
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1169
Practice Address - Country:US
Practice Address - Phone:419-291-2670
Practice Address - Fax:419-479-6999
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35026619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000141237OtherANTHEM
OH0074762Medicaid
OH01-03141OtherUHC
OH00229OtherPHC
OH203089OtherBLACK LUNG
OH0633289OtherAETNA
OH0633289OtherAETNA
OHFI0447054Medicare ID - Type Unspecified