Malone, Randolph Augustus

Malone, Randolph Augustus is an sole proprietor health care provider with primary practice located at 2804 Remington Green Circle Ste1 , Tallahassee FL 32308. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Malone, Randolph Augustus can be contacted via phone (850) 656-6269.

Contact Information

Primary practice address
2804 Remington Green Circle Ste1 Tallahassee FL 32308
Fax: (850) 877-5270
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Other Service Providers / Specialist 174400000X 060041
Allopathic & Osteopathic Physicians / Allergy 207KA0200X 034412 Georgia

Profile Details

NPI number 1497726814
LBN Legal business name Malone, Randolph Augustus
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2006
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497726814 NPPES
Georgia MEDICAID 000465671A

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