Organization Active NPI

Randall P Leduc, MD, PC

  • Internal Medicine Physician
  • Dillsboro, IN
National Provider Identifier
1942429352
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50003548A Issued in IN
Legal business name
RANDALL P LEDUC, MD, PC
Practice address
12827 Lenover St
Dillsboro, IN 47018-0095
Phone
(812) 432-3600
Fax
(812) 432-3702
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Randall P Leduc, MD
Title
President
Phone
(812) 432-3600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 50003548A IN
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 50003548A IN Primary

Addresses

Primary practice location

12827 Lenover St
Dillsboro, IN 47018-0095

Mailing address

PO Box 95
12827 Lenover St
Dillsboro, IN 47018-0095
Phone (812) 432-3600

Other identifiers 1

IdentifierTypeStateIssuer
200279400AMedicaidIN

National Provider Directory

National Provider Directory

Locations

12827 Lenover St
Dillsboro, IN 47018
Phone (812) 432-3600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1942429352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "address_2": "12827 LENOVER ST",
            "city": "DILLSBORO",
            "state": "IN",
            "postal_code": "470180095",
            "telephone_number": "812-432-3600",
            "fax_number": "812-432-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12827 LENOVER ST",
            "city": "DILLSBORO",
            "state": "IN",
            "postal_code": "470180095",
            "telephone_number": "812-432-3600",
            "fax_number": "812-432-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL P LEDUC, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "LEDUC",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-432-3600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "50003548A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "50003548A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200279400A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillsboro, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.