Provider Demographics
NPI:1932172509
Name:SCHICK, RANDALL C I (DO)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:C
Last Name:SCHICK
Suffix:I
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:USCG HQ, COMDT (CG-1122)
Mailing Address - Street 2:2100 2ND STREET SW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20593-0001
Mailing Address - Country:US
Mailing Address - Phone:907-487-5757
Mailing Address - Fax:907-487-5360
Practice Address - Street 1:BLDG N-46 CAPE SARICHEF
Practice Address - Street 2:
Practice Address - City:KODIAK
Practice Address - State:AK
Practice Address - Zip Code:99619-5002
Practice Address - Country:US
Practice Address - Phone:907-487-5757
Practice Address - Fax:907-487-5360
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31383-021207Q00000X
AK2896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine