Individual
MICHAEL L. RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
101 13TH ST, SUITE 200, COLUMBUS, GA 31901-2101
(706) 494-4949
(706) 494-4940
Mailing address
PO BOX 1038, COLUMBUS, GA 31902-1038
(706) 494-4949
(706) 494-4940
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-517
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005031
LICENSE
GA
01
—
PA-517
STATE LICENSE
AL
Enumeration date
03/07/2007
Last updated
12/07/2015
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