Individual
MR. RANDALL W MCCARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
711 KNIGHT AVE, WAYCROSS, GA 31501-1943
(912) 283-9423
(912) 283-2946
Mailing address
711 KNIGHT AVE, WAYCROSS, GA 31501-1943
(912) 283-9423
(912) 283-2946
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000666
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891875878
MEDICARE NPI
GA
05
—
476568664A
—
GA
01
—
CG6045
RAILROAD MEDICARE GROUP ID
GA
Enumeration date
10/16/2006
Last updated
06/11/2021
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