Provider Demographics
NPI:1568776334
Name:METZGER, RANDY J (DPM)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:J
Last Name:METZGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-3703
Mailing Address - Country:US
Mailing Address - Phone:515-343-4180
Mailing Address - Fax:515-461-9995
Practice Address - Street 1:1517 N 1ST ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-3703
Practice Address - Country:US
Practice Address - Phone:515-666-1222
Practice Address - Fax:515-461-9995
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000877213E00000X, 213ES0103X
PASC006209213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist