| Thomas R Randall, MD | |
| 
					1275 N High St, Hillsboro, OH 45133-8273  | |
| (937) 393-6140 | |
| Not Available | 
| Full Name | Thomas R Randall | 
|---|---|
| Gender | Male | 
| Speciality | Emergency Medicine | 
| Location | 1275 N High St, Hillsboro, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1326012832 | NPI | - | NPPES | 
| 000000344443 | Other | OH | ANTHEM BCBS | 
| P00190832 | Other | RAILROAD MEDICARE | |
| 2418155 | Medicaid | OH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 35-073247 (Ohio) | Secondary | 
| 207P00000X | Emergency Medicine | 35.073247 (Ohio) | Primary | 
| Entity Name | Highland District Hospital | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1225053119 PECOS PAC ID: 0941191167 Enrollment ID: O20040324001232  | 
| Entity Name | Ohio Emergency Professionals Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1982983425 PECOS PAC ID: 0547433328 Enrollment ID: O20111024000785  | 
| Entity Name | Valley Emergency Physicians Ohio Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1528342961 PECOS PAC ID: 8527233261 Enrollment ID: O20111208000543  | 
| Entity Name | Osup Community Outreach Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1699179929 PECOS PAC ID: 5799008082 Enrollment ID: O20141217001070  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Thomas R Randall, MD 968 Waynoka Dr, Lake Waynoka, OH 45171-9762 Ph: (937) 446-1639  | Thomas R Randall, MD 1275 N High St, Hillsboro, OH 45133-8273 Ph: (937) 393-6140  | 
Dr. Michael P. Parker, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1275 N High St, Hillsboro, OH 45133 Phone: 937-393-6100 Fax: 614-293-2809  | |
Keith J Harkins, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1275 N High St, Hillsboro, OH 45133 Phone: 937-393-6100 Fax: 937-619-4150  | |
Leslie Rea Kallevang, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1275 N High St, Hillsboro, OH 45133 Phone: 937-393-6100 Fax: 614-293-2809  | |
Dr. Brad Stewart Goldman, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1275 N High St, Hillsboro, OH 45133 Phone: 937-393-6100 Fax: 614-293-2809  |