National Provider Identifier Database

RANDALL S WHITESIDE, CP – NPI #1871017137
Prosthetist

An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both


Contact Information

RANDALL S WHITESIDE, CP
1190 E MISSOURI AVE STE 190
PHOENIX, AZ85014-2736
Phone: 602-312-6605
Fax: 480-212-5944
Website:
Specialty Taxonomy Code
* Prosthetist 224P00000X

* Indicates primary specialty

NPI Profile & details for RANDALL S WHITESIDE

NPI Number 1871017137
Credentials CP
Entity Individual
Enumeration date 07/28/2017
Last updated 03/17/2018 - About 8 years ago
Sole proprietor1 No
Identifiers n/a
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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