Kelly Randall MD INC

NPI #1831401298 in Fremont, Ohio

Provider Information

NPI Number: 1831401298
Entity Type: Organization
Organization Name: Kelly Randall MD INC
Primary Specialty: Specialist
Enumeration Date: Jul 13, 2010
Last Updated: Mar 21, 2013

Practice Location

Address: 605 3RD AVE
Address 2: SUITE F
City: Fremont
State: Ohio
ZIP Code: 43420-3269
Phone: (419) 332-7311

Authorized Official

Name: DR. KELLY RANDALL, M.D.
Title: PRESIDENT
Phone: (419) 332-7311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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