Organization
RANDALL HUMPHREYS P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL F HUMPHREYS M.D. (PRESIDENT)
(850) 785-2717
Entity
Organization
Contact information
Practice address
2401 SAINT ANDREWS BLVD, PANAMA CITY, FL 32405-2170
(850) 785-2717
(850) 785-2301
Mailing address
2401 SAINT ANDREWS BLVD, PANAMA CITY, FL 32405-2170
(850) 785-2717
(850) 785-2301
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME59222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052572300
—
FL
01
—
12097
BCBS OF FLORIDA
FL
Enumeration date
08/31/2006
Last updated
08/02/2010
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