# RANDOLPH MEDICAL ASSOCIATES, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497815120
- **Authorized official:** RUSSELL D PETERSON DO (PRESIDENT)
- **Authorized official phone:** (334) 863-2141

## Contact information

- **Practice address:** 965 US HWY 431, ROANOKE, AL 36274
- **Practice address phone:** (334) 863-2141
- **Practice address fax:** (334) 863-8733
- **Mailing address:** PO BOX 625, 965 US HWY 431, ROANOKE, AL 36274-0625
- **Mailing address phone:** (334) 863-2141
- **Mailing address fax:** (334) 863-8733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | DO-436 | AL | Yes |

## Other

- **Enumeration date:** 12/11/2006
- **Last updated:** 08/22/2020