Individual
JASON THOMAS RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
454 TAYLOR RD, MONTGOMERY, AL 36117-3563
(334) 613-9000
(334) 532-0056
Mailing address
454 TAYLOR RD, MONTGOMERY, AL 36117-3563
(334) 613-9000
(334) 532-0056
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD.27730
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111355
—
AL
05
—
111912
—
AL
05
—
111923
—
AL
01
—
5149399
BCBS
—
Enumeration date
10/11/2006
Last updated
03/27/2014
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