Randall J Blazic, DDS MD is a
Oral & Maxillofacial Surgery based in Goodyear, Arizona. Randall J Blazic is licensed to practice in Arizona (license number M31657) and his current practice location is
1646 N Litchfield Road, Suite 130, Goodyear, Arizona. He can be reached at his office (for appointments etc.) via phone at
(623) 935-5774.
NPI number for Randall J Blazic is 1497843445 and his current mailing address is 1646 N Litchfield Road, Suite 130, Goodyear, Arizona. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1497843445.
Healthcare Provider's Profile
Full Name | Randall J Blazic |
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Gender | Male |
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Speciality | Oral & Maxillofacial Surgery |
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Location | 1646 N Litchfield Road, Goodyear, Arizona |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1497843445
- Provider Enumeration Date: 10/11/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Randall J Blazic such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1497843445 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | D5976 (Arizona) | Primary |
204E00000X | Oral & Maxillofacial Surgery | M31657 (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Randall J Blazic is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Randall J Blazic, DDS MD 1646 N Litchfield Road, Suite 130, Goodyear, AZ 85338 Ph: (623) 935-5774 | Randall J Blazic, DDS MD 1646 N Litchfield Road, Suite 130, Goodyear, AZ 85338 Ph: (623) 935-5774 |
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