Basic Information
| Provider Information | |||||||||
| NPI: | 1407814965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OLDROYD | ||||||||
| FirstName: | RANDALL | ||||||||
| MiddleName: | KYLE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 750 WELLINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815016132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702987500 | ||||||||
| FaxNumber: | 9702987262 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 S 5TH ST | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814015711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702407242 | ||||||||
| FaxNumber: | 9702407793 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2006 | ||||||||
| LastUpdateDate: | 01/22/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 44421 | CO | Y | Other Service Providers | Specialist |
No ID Information.