| Doctor Name: | DR. RANDALL BART KISER |
| NPI Number: | 1366550477 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | M7191 |
| Business Practice Address: | 457 E 900 S Mapleton, UT - 846645019 |
| Business Phone Number: | 9525951100 |
| Business Fax Number: | 6122944903 |
| Mailing Address: | 11995 Singletree Ln, Ste 500 EDEN PRAIRIE |
| State: | MN |
| Postal Code: | 553445347 |
| Phone Number: | 9525951301 |
| Fax Number: | 6122944903 |
| NPI Enumeration Date: | 08/28/2006 |
| NPI Last Update Date: | 06/23/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | M7191 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |