| Doctor Name: | DR. GEORGE ETHAN RANDALL |
| NPI Number: | 1538596515 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 60-082606 |
| Business Practice Address: | 1810 Tamarack Trl Skaneateles, NY - 13152 |
| Business Phone Number: | 3156857193 |
| Business Fax Number: | 3156857193 |
| Mailing Address: | 1810 Tamarack Trl, SKANEATELES |
| State: | NY |
| Postal Code: | 13152 |
| Phone Number: | 3156857193 |
| Fax Number: | 3156857193 |
| NPI Enumeration Date: | 10/04/2013 |
| NPI Last Update Date: | 10/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 60-082606 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |