Individual
MR. DERRICK AARON RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1207 7TH ST S.E., DECATUR/MORGAN HOSPITAL - PARKWAY CAMPUS, DECATUR, GA 35601
(256) 341-2000
Mailing address
2030 CLEVELAND AVE S.W, DECATUR, AL 35601
(256) 353-3501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-090988
AL
363LF0000X
Family Nurse Practitioner
Primary
1-090988
AL
390200000X
Student in an Organized Health Care Education/Training Program
1-090988
AL
Other
Enumeration date
08/28/2014
Last updated
01/27/2015
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