Randolph Clay O'Dell in Walled Lake - Chiropractor
Randolph Clay O'Dell - NPI 1477644375
Randolph Clay O'Dell is a Chiropractor in Walled Lake, Michigan. Randolph Clay O'Dell practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Randolph Clay O'Dell is 1477644375. The last update date is 2007-07-09.
Randolph Clay O'Dell's current location address is 1183 Pontiac Trail, Walled Lake, Michigan. You can contact this provider via phone number 2486246111 and fax number 2486246129. The mailing address for Randolph Clay O'Dell is 1183 Pontiac Trail, Walled Lake, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randolph Clay O'Dell |
|---|---|
| Address | 1183 Pontiac Trail, Walled Lake, Michigan |
| Phone Number | 2486246111 |
| Fax Number | 2486246129 |
| Sole Proprietor | Y |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1477644375 |
|---|---|
| Provider Enumeration Date | 2006-09-27 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 1183 Pontiac Trail |
|---|---|
| City | Walled Lake |
| State | Michigan (MI) |
| Post Code | 48390 |
| Phone Number | 2486246111 |
| Fax Number | 2486246129 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 2301002842 |
|
Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1279839 | MI | -- | |
| 142073 | MI | AETNA INSURANCE |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Randolph Clay O'Dell by the Centers for Medicare & Medicaid Services?
The Randolph Clay O'Dell has been issued the NPI (National Provider Identifier) 1477644375 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Randolph Clay O'Dell's facilities are situated?
The facilities of Randolph Clay O'Dell are physically located at the following address: 1183 Pontiac Trail, Walled Lake, MI, 48390.
What is Randolph Clay O'Dell's area of expertise and its corresponding taxonomy classification?
The Randolph Clay O'Dell's field of specialization is Chiropractor, and it falls under the taxonomy code 111N00000X, which categorizes healthcare providers based on their areas of practice.
When did Randolph Clay O'Dell receive its 1477644375 assignment?
The Randolph Clay O'Dell was assigned its 1477644375 on 2006-09-27, which is the date when this unique identifier was issued to the organization.
As of what date was the information regarding Randolph Clay O'Dell, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Randolph Clay O'Dell, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-09.
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