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RANDY WHITESIDE PROSTHETICS LLC

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

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Contact Information

RANDY WHITESIDE PROSTHETICS LLC
1190 E MISSOURI AVE STE 190
PHOENIX, AZ  85014-2736
 Phone: 602-596-1040
 Fax: 480-212-5944
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Prosthetist

 224P00000X 56 Individual Certified Prosthetist
Indicates primary specialty

NPI Profile & details for RANDY WHITESIDE PROSTHETICS LLC

NPI Number 1609386853
LBN Legal business name RANDY WHITESIDE PROSTHETICS LLC
Authorized official RANDALL WHITESIDE - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/02/2017
Last updated 10/02/2017 - About 9 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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