Individual
MR. TIMMOTHY R RANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3444 MASONIC DRIVE, ALEXANDRIA, LA 71301
(318) 473-9556
(318) 441-8339
Mailing address
3444 MASONIC DRIVE, ALEXANDRIA, LA 71301
(318) 473-9556
(318) 441-8339
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2014-00216
NC
207X00000X
Orthopaedic Surgery Physician
Primary
MD208009
LA
390200000X
Student in an Organized Health Care Education/Training Program
BP10033781
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2428543
—
LA
Enumeration date
07/15/2009
Last updated
08/18/2023
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