Individual
M. BARRY RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
930 MADISON AVE, SUITE 890, MEMPHIS, TN 38103-3410
(901) 866-8834
(901) 302-2834
Mailing address
1068 CRESTHAVEN RD STE 300, MEMPHIS, TN 38119-0809
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
29321
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
29321
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0121423
—
MS
05
—
133395001
—
AR
05
—
1532078
—
TN
Enumeration date
12/02/2005
Last updated
02/25/2025
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