Randall C Blake (NPI# 1447226055, PAC ID# 6901872720) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1447226055 |
| PAC ID by PECOS | 6901872720 |
| Professional Enrollment ID | I20070919000999 |
| Full Name | Randall C Blake |
| Organization Legal Name | ISLAND UROLOGY OAHU LLC |
| Address |
3-3295 Kuhio Hwy 203 Lihue HI 96766-1035 |
| Phone Number | 8082464707 |
| Gender | M |
| Credential | MD |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1979 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 1951553551 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1329 Lusitana St, Suite 602, Honolulu, HI 96813-2431 | 8085225055 | ISLAND UROLOGY OAHU LLC |
| 3-3295 Kuhio Hwy 203, Lihue, HI 96766-1035 | 8082464707 | ISLAND UROLOGY OAHU LLC |
| Organization Legal Name | ISLAND UROLOGY OAHU LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sergei Tikhonenkov | Urology | Island Urology Oahu LLC | 1329 Lusitana St, Suite 602, Honolulu, HI 96813-2431 |
| Ulrich K Stams | Urology | Island Urology Oahu LLC | 1329 Lusitana St, Suite 602, Honolulu, HI 96813-2431 |
| Street Address |
3-3295 KUHIO HWY 203 |
| City | LIHUE |
| State | HI |
| Zip | 96766-1035 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Liliane L Kheng | Family Medicine | Hawaii Family Medical Centers | 3-3295 Kuhio Hwy, Lihue, HI 96766-1040 |
| Raymond Joseph Martinez | Family Medicine | Hawaii Family Medical Centers | 3-3295 Kuhio Hwy, Lihue, HI 96766-1040 |
| Karen J Young | Certified Registered Nurse Anesthetist (crna) | 3-3420 Kuhio Hwy, Lihue, HI 96766-1042 | |
| Nicholas M Leonard | Emergency Medicine | Kauai Medical Clinic | 3-3420 Kuhio Hwy B, Lihue, HI 96766-1098 |
| Robert Todd Mathis | Obstetrics/gynecology | Kauai Medical Clinic | 3-3420 Kuhio Hwy B, Lihue, HI 96766-1098 |
| Jennifer A Ballard | Nurse Practitioner | Kauai Medical Clinic | 3-3420 Kuhio Hwy B, Lihue, HI 96766-1098 |
| Summer Douban | Internal Medicine | Kauai Medical Clinic | 3-3420 Kuhio Hwy B, Lihue, HI 96766-1098 |
| Ryan G Mcmorries | Emergency Medicine | Kauai Medical Clinic | 3-3420 Kuhio Hwy B, Lihue, HI 96766-1098 |
| Joseph W Burris Jr. | Emergency Medicine | Kauai Medical Clinic | 3-3420 Kuhio Hwy B, Lihue, HI 96766-1098 |
| Andrew U So | Cardiovascular Disease (cardiology) | Kauai Medical Clinic | 3-3420 Kuhio Hwy B, Lihue, HI 96766-1098 |
| Find all physicians in zip 96766 | |||
| City | LIHUE |
| Zip Code | 96766 |
| Specialty | UROLOGY |
| City + Specialty | LIHUE + UROLOGY |
Please comment or provide details below to improve the information on Randall C Blake.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.