Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD070025L | PA |
Y | 2080P0216X | Pediatric Rheumatologist | 28205 | AL |
N | 2080P0216X | Pediatric Rheumatologist | MD070025L | PA |
NPI | 1053331561 |
---|---|
Provider Name | Randall Q Cron |
First Address | Birmingham, AL 35294-0001 |
Second Address | Birmingham, AL 35233-1711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 25/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001776861 | (05) | PA |
009910739 | (05) | AL |
8068607 | (05) | NJ |
G62880 | (02) |