Individual
RANDALL KEITH FALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4519 BRAMBLETON AVE, SUITE # 302, ROANOKE, VA 24018-3436
(540) 772-4448
(540) 772-0410
Mailing address
PO BOX 20764, ROANOKE, VA 24018-0077
(540) 772-4448
(540) 772-0410
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101041068
VA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101041068
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407878846
—
VA
01
—
1508030081
MEDICAID GIN
VA
Enumeration date
07/24/2006
Last updated
08/19/2025
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