# MR. TIMMOTHY R RANDELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1245460013
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 2014-00216 | NC | — |
| 207X00000X | Orthopaedic Surgery Physician | MD208009 | LA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | BP10033781 | TX | — |

## Other

- **Enumeration date:** 07/15/2009
- **Last updated:** 08/18/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2428543 | — | LA |