Provider Demographics
NPI:1669120119
Name:RAUSCH, RANDALL GEORGE
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:GEORGE
Last Name:RAUSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22957 STATE ROUTE 751
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:OH
Mailing Address - Zip Code:43845-9737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22957 STATE ROUTE 751
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:OH
Practice Address - Zip Code:43845-9737
Practice Address - Country:US
Practice Address - Phone:740-610-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHIL.03460237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist