Provider Demographics
NPI:1477521888
Name:REPLOGLE, JOHN RANDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RANDALL
Last Name:REPLOGLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9040 REID ST
Mailing Address - Street 2:ATTN MCHJ QCR MADIGAN ARMY MEDICAL CENTER
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-1100
Mailing Address - Country:US
Mailing Address - Phone:253-968-2252
Mailing Address - Fax:253-968-3278
Practice Address - Street 1:9040 REID ST
Practice Address - Street 2:ATTN MCHJ QCR MADIGAN ARMY MEDICAL CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-1100
Practice Address - Country:US
Practice Address - Phone:253-968-2252
Practice Address - Fax:253-968-3278
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2014-01-31
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Provider Licenses
StateLicense IDTaxonomies
WAMD20360207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN