Doctor Name: | MR. RANDALL ALLEN WARNER |
NPI Number: | 1083914055 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 051553419 |
Business Practice Address: | 398 Turnerwoods Rd Gray, GA - 310325700 |
Business Phone Number: | 8885078090 |
Business Fax Number: | 8664397426 |
Mailing Address: | 398 Turnerwoods Rd, GRAY |
State: | GA |
Postal Code: | 310325700 |
Phone Number: | 8885078090 |
Fax Number: | 8664397426 |
NPI Enumeration Date: | 10/25/2010 |
NPI Last Update Date: | 10/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | 051553419 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |