MD Gerald Randle, NPI 1497769665
Neurology Physician in Jackson, MS, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1497769665
NPI Entity Type Individual
Provider Name MD Gerald Randle
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Provider Location Address 1200 N State St, Suite 420, Jackson, MS, US
Provider Mailing Address 1151 N State St, Suite 504, Jackson, MS, US, 392022407
Is Sole Proprietor? No
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Primary Taxonomy

Taxonomy Code

2084N0400X

Taxonomy Name Neurology Physician
Classification

Psychiatry & Neurology

Group

Allopathic & Osteopathic Physicians

License No. 06233
License State MS
Description A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Business Address

MD Gerald Randle
1200 N State St
Suite 420

Jackson, MS, US

Phone: 601-355-3353
Fax: 601-355-3365

Mailing Address

MD Gerald Randle
1151 N State St
Suite 504
Jackson, MS, US
ZIP 392022407
Phone: 601-292-4261
Fax: 601-292-4262

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
P00466199 RR MEDICARE 01
300002201 MS US DEPT OF LABOR 01
753068151 MS MPCN 01
00124228 MS MEDICAID 05
753068151 MS MHP 01
753068151014 TRICARE 01

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IDD WAIVER SERVICES Pamela Mcandrews

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