Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RANDALL JAY SAMPSON
Active Sole ProprietorRANDALL JAY SAMPSON is a Contractor healthcare provider located in FOREST LAKE, Minnesota. NPI 1295366029 is currently active in the NPPES registry. Verify at CMS.
Contractor · FOREST LAKE, MN
Registration Details
- NPI Number
- 1295366029
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 30, 2020 (6.548627450868 yrs)
- Last Updated
- Jan 30, 2020
- License
-
BC743839 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
24668 HAMLET AVEFOREST LAKE, MN, 550258781Browse MN providers · Browse ZIP 55025
- Phone
- 6122909056
- Fax
- 6514645671
- Primary Specialty
-
Contractor
171W00000X
Other Contractor Providers in FOREST LAKE, MN
| Name | Credential | NPI |
|---|---|---|
| MS. TABATHA L OBERT | — | 1457599714 |
| MARK KROPIDLOWSKI | — | 1538910385 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.