Randle, Gerald

Randle, Gerald is an individual health care provider with primary practice located at 1200 N State St Suite 420, Jackson MS 39202-2000. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Randle, Gerald can be contacted via phone (601) 355-3353.

Contact Information

Primary practice address
1200 N State St Suite 420 Jackson MS 39202-2000
Phone: (601) 355-3353
Fax: (601) 355-3365
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 06233 Mississippi

Profile Details

NPI number 1497769665
LBN Legal business name Randle, Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Jan 14th, 2014 - about 11 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 1497769665 NPPES
Other P00466199 RR MEDICARE
Other 300002201 RR MEDICARE
Other 753068151 RR MEDICARE
MEDICAID 00124228 RR MEDICARE
Other 753068151 RR MEDICARE
Other 753068151014 RR MEDICARE

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