Provider Demographics
NPI:1811390198
Name:J RANDALL RAUH MD INC
Entity Type:Organization
Organization Name:J RANDALL RAUH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-234-7660
Mailing Address - Street 1:330 ROGER LN STE 4
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-9239
Mailing Address - Country:US
Mailing Address - Phone:406-234-7660
Mailing Address - Fax:406-234-7664
Practice Address - Street 1:330 ROGER LN STE 4
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-9239
Practice Address - Country:US
Practice Address - Phone:406-324-7660
Practice Address - Fax:406-234-7664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTDO7937Medicare UPIN