Individual provider · Type 1 NPI
Altheal Randolph, PA
Medical Physician Assistant · Jemison, AL
NPI number
1376093864
Active
Practice location
340 County Road 126
Jemison, AL 35085-3106
Fax (205) 688-2545
Mailing address
340 County Road
Jemison, AL 35085-3106
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA190 (AL) |
Medical Physician Assistant: Definition to come...
About NPI 1376093864
Altheal Randolph, PA's National Provider Identifier is 1376093864, issued on Oct 7, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Jemison, AL. The record was last updated on Oct 7, 2016.