Individual provider · Type 1 NPI

Randall T. Mathis, PA-C

Surgical Physician Assistant · St. Augustine, FL

NPI number 1922055391 Active

Practice location

100 Whetstone Pl, Ste 310
St. Augustine, FL 32086-5774

Call (904) 217-7450 Map

Fax (904) 217-7483

Mailing address

PO Box 3123
St. Augustine, FL 32085-3123

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA9101202 (FL)
Surgical Physician Assistant Primary 363AS0400XPA9101202 (FL)

Surgical Physician Assistant: Definition to come...

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About NPI 1922055391

Randall T. Mathis, PA-C's National Provider Identifier is 1922055391, issued on May 30, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in St. Augustine, FL. The record was last updated on Apr 16, 2012.