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RANDALL LEE PROCTOR M.D. NPI 1366880304


NPI Information

NPI: 1366880304
Provider Name: RANDALL LEE PROCTOR, M.D.
Classification: Dermatology - 207ND0101X
Entity Type: Individual

Specialization: MOHS-Micrographic Surgery

Organization: EASTERN DERMATOLOGY PA

PECOS Registration: Yes

Address:
420 SPRING FOREST RD
GREENVILLE, NC
ZIP 27834
Phone: (252) 752-4124
Get Directions

Randall Lee Proctor, M.D. is a mohs-micrographic surgery dermatology in Greenville, NC with 11 years of experience. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. Randall Lee Proctor, M.D. NPI is 1366880304. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduation Year:2013

The provider's business location address is:

420 SPRING FOREST RD
GREENVILLE, NC
ZIP 27834
Phone: (252) 752-4124
Fax: (252) 752-2044

The NPI 1366880304 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/12/2013 and was last updated on 8/1/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207ND0101XDermatologyMOHS-Micrographic Surgery2016-02476NORTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.