Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
DR. TOMMY LAVAUGHN RANDOLPH
Active
Individual
DR. TOMMY LAVAUGHN RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME46235
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004055514
AETNA
FL
01
—
030335
AVMED
FL
05
—
041374700
—
FL
01
—
080154675
RRMEDICARE
FL
01
—
12070
BCBS
FL
01
—
1992805881
NPI
FL
Enumeration date
09/22/2006
Last updated
01/03/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up