Provider Demographics
NPI:1629154232
Name:SCHUBERT, RANDALL DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:DEAN
Last Name:SCHUBERT
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 1:3535 NW 58TH ST
Mailing Address - Street 2:SUITE 950 E
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4804
Mailing Address - Country:US
Mailing Address - Phone:405-702-8623
Mailing Address - Fax:405-702-8628
Practice Address - Street 1:3535 NW 58TH ST
Practice Address - Street 2:SUITE 950 E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4804
Practice Address - Country:US
Practice Address - Phone:405-702-8623
Practice Address - Fax:405-702-8628
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor