IndividualActive
Randall Whiteside, CP
NPI 1871017137 · Prosthetist · Phoenix, AZ
Provider details
- NPI number
- 1871017137
- Entity type
- Individual
- Primary specialty
- ProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CP
- Sex
- Male
- Sole proprietor
- No
Practice location
1190 E Missouri Ave Ste 190
Phoenix, AZ 85014-2736
Phone: (602) 312-6605
Fax: (480) 212-5944
Mailing address
5347 E Mockingbird Ln
Paradise Valley, AZ 85253-2521
Registry dates
- Enumerated
- 2017-07-28
- Last updated
- 2018-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.