Provider Demographics
NPI:1679587612
Name:GUBLER, RANDY LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:LEE
Last Name:GUBLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3320 NORTH BUFFALO DRIVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7410
Mailing Address - Country:US
Mailing Address - Phone:702-256-8454
Mailing Address - Fax:702-256-0387
Practice Address - Street 1:3320 NORTH BUFFALO DRIVE
Practice Address - Street 2:SUITE 107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7410
Practice Address - Country:US
Practice Address - Phone:702-256-8454
Practice Address - Fax:702-256-0387
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9804213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1943324OtherUNITED HEALTH CARE
NVCC1573OtherBLUE CROSS/BLUE SHIELD
NV480029166OtherRAILROAD MEDICARE
NV7208106OtherAETNA
NV002102006Medicaid
NV1943324OtherUNITED HEALTH CARE
NV002102006Medicaid
NV7208106OtherAETNA