LISA M RANDON MD LLC
NPI 1699295659
Pediatrics in Detroit, MI

Q: What is Lisa M Randon MD LLC's NPI number?

The NPI number for Lisa M Randon MD LLC is 1699295659. It was assigned to this organization in the NPPES registry on June 21, 2017.

Q: What is Lisa M Randon MD LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since June 21, 2017

3990 JOHN R ST, DETROIT, MI 48201(313) 745-5111 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2018, Jun 21, 2017 (2 updates tracked since 2017).

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About Lisa M Randon Md Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA M RANDON MD LLC (NPI 1699295659) is a healthcare organization registered as a pediatrics in Detroit, Michigan and active in the NPI registry since June 2017. The organization maintains a secondary practice location in Detroit and lists Lisa Marie Randon, Physician, as its authorized official.

NPPES Registry Identity

NPI1699295659

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameLISA M RANDON MD LLC

Location Address3990 JOHN R STDetroit, MI 48201-2018

Mailing Address1401 W Fort St Unit 442450Detroit, MI 48244-3599 · (313) 608-1510 · Fax (313) 656-4056

Phone(313) 745-5111

Organization SubpartNo

Authorized OfficialLisa Marie RandonPhysician · (313) 608-1510

Enumeration DateJune 21, 2017

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1699295659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MI · 4301068207

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

3990 JOHN R ST, Detroit, MI 48201

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Secondary Practice Location 1

Location 16071 W Outer DrDetroit, MI 48235-2624 · Phone (313) 745-5111 ext. 6091

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBERLY DAWN HARRIS CRNA

Nurse Anesthetist, Certified Registered