Provider Demographics
NPI:1184706624
Name:FEHR, RANDALL W (MD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:W
Last Name:FEHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10371 N ORACLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-9394
Mailing Address - Country:US
Mailing Address - Phone:520-877-3336
Mailing Address - Fax:520-877-3339
Practice Address - Street 1:10371 N ORACLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-9394
Practice Address - Country:US
Practice Address - Phone:520-877-3336
Practice Address - Fax:520-877-3339
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ213072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ342105Medicaid
B06837Medicare UPIN
AZ342105Medicaid