Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | RL070418 | MI |
Y | 207XS0106X | Orthopaedic Hand Surgeon | RL070418 | MI |
NPI | 1245345503 |
---|---|
Provider Name | Dr. Randy F R Lovell III |
First Address | Grand Rapids, MI 49546-6142 |
Second Address | Grand Rapids, MI 49546-6142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 23/10/2019 |