RANDY S. LARGE

JOPLIN, MO
NPI1538149778
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: MO  2010000744)
Additional Taxonomies207L00000X Anesthesiology
(Licence: CO  DR-34380)
207L00000X Anesthesiology
(Licence: AZ  3086)
Enumeration Date2006-01-21
Last Update Date2010-10-01
Business Address
-- RANDY S. LARGE DO
1102 W 32ND ST
JOPLIN, MO 64804-3503
Phone number: 417-347-3649
Mailing Address
-- RANDY S. LARGE DO
PO BOX 3810
JOPLIN, MO 64803-3810
Phone number: 417-347-3649