Provider Demographics
NPI:1568607935
Name:GUDEIKA, RANDY JAY
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:JAY
Last Name:GUDEIKA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:RANDY
Other - Middle Name:JAY
Other - Last Name:GUDEIKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2145 CENTENNIAL PLAZA
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2421
Mailing Address - Country:US
Mailing Address - Phone:541-485-6340
Mailing Address - Fax:541-984-3124
Practice Address - Street 1:2145 CENTENNIAL PLAZA
Practice Address - Street 2:LAUREL HILL CENTER
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2421
Practice Address - Country:US
Practice Address - Phone:541-485-6340
Practice Address - Fax:541-984-3124
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist