NPI 1194726380

Geoffrey M Randolph, MD

Practitioner Plastic Surgery Physician Fort Wayne, IN

Practice location

Address: 11141 Parkview Plaza Dr STE 300, Fort Wayne, IN 46845-1715
Phone: (260) 490-7111
Fax: (260) 490-9301
Mailing address: 7230 Engle Rd, Fort Wayne, IN 46804-2209

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 01035742A (IN)

Other Plastic Surgery providers in Indiana →

Registry record

NPI: 1194726380
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Aug 2005
Record last updated: 23 Jul 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.