Randolph, Gregory W
Randolph, Gregory W is an individual health care provider with primary practice located at 130 Fleitas Ave , Pass Christian MS 39571-4507. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Randolph, Gregory W can be contacted via phone (228) 452-4888.Contact Information
Primary practice address
130 Fleitas Ave
Pass Christian MS 39571-4507
Phone: (228) 452-4888
Fax: (228) 452-5006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 13081 | Mississippi |
Profile Details
| NPI number | 1699760652 |
|---|---|
| LBN Legal business name | Randolph, Gregory W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699760652 | NPPES |
| Mississippi | MEDICAID | 00117253 |
Popular Providers
-
Kauffman, Stephen C
3450 N Beauregard St Ste 1, Alexandria VA 22302-1200 -
Perez-Montes, Marcelo R.
100 Ironcreek Pl , Apex NC 27539-7772 -
De Leon, Sylvette
Centro Comercial Rio Piedras Heights Calle Parana 1689 Ofic #5, San Juan PR 00926 -
Russell, Allen J
32401 8 Mile Rd , Livonia MI 48152-1301 -
Kirby, Melissa C
12301 Lake Underhill Rd Ste 215 , Orlando FL 32828-4511 -
Tong, William F
1505 Main St , Watsonville CA 95076-3761 -
Cummings, James R.
27297 Charlick Rd , Brooksville FL 34602-8217 -
Prysi, Scott
501 Lighthouse Ave , Monterey CA 93940-1439