Randall Tobler, M.D.

Individual provider Active NPI Obstetrics & Gynecology Physician · Memphis, MO

NPI 1639190069 · NPPES record last updated Mar 10, 2008

Key facts

NPI
1639190069
Entity type
Individual (NPI type 1)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
License
R2F89 (MO)
Practice address
Sigler Ave
R1
Memphis, MO 63555
Phone
(660) 465-2828
Fax
(660) 465-2820
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Scotland County Hospital
Memphis, MO · CCN 26Z310
Hospital Corporate Officer (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)
Aug 29, 2014
Aug 29, 2014
Aug 29, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20061114000214 MO Practitioner - Obstetrics/Gynecology
Practitioner - Gynecological Oncology
0042218711 Reassigns benefits to 3 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Macon County Samaritan Hospital Current
since Oct 12, 2006
Accepting new patients
Scotland County Memorial Hospital Current
since Sep 1, 2006
Accepting new patients
Scotland County Memorial Hospital Current
since Sep 1, 2006
Accepting new patients
Scotland County Memorial Hospital Current Accepting new patients
Macon County Samaritan Hospital Obstetrics & Gynecology Past Accepting new patients
Scotland County Memorial Hospital Past Accepting new patients

Locations

1205 N Missouri St
Macon, MO 63552
Phone (660) 385-3151

450 E Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

450 E Sigler Ave
Ste A
Memphis, MO 63555
Phone (660) 465-2828

Interoperability endpoints

  • Direct secure messaging: randall.tobler@507399380271108.direct.elationemr.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X R2F89 MO Yes

Addresses

Primary practice location

Sigler Ave
R1
Memphis, MO 63555

Mailing address

R1 Box 54
Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

Other providers in Memphis, MO

All providers in Memphis, MO · Obstetrics & Gynecology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.