RICHARD C RANDOLPH MD PA NPI 1679672745

NPI Information

  • NPI: 1679672745
  • Provider Name: RICHARD C RANDOLPH MD PA
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 348 CROSSGATES BLVD
    SUITE 2200
    BRANDON, MS
    ZIP 39042
  • Phone: (601) 825-2466

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NPI Details

RICHARD C RANDOLPH MD PA is a family medicine in Brandon, MS. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RICHARD C RANDOLPH MD PA NPI is 1679672745. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

348 CROSSGATES BLVD
SUITE 2200
BRANDON, MS
ZIP 39042-616
Phone: (601) 825-2466
Fax: (601) 824-8137

The provider's authorized official is Richard C Randolph .
The authorized official title is President and has the following contact phone number (601) 825-2466.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 8/15/2011.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine10006MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
103920519MEDICAIDMISSISSIPPI
2B66164MEDICARE UPINMISSISSIPPI
3DG3008OTHERMISSISSIPPIPALMETTO GBA RAILROAD MEDICARE
4C03418MEDICARE PINMISSISSIPPI

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: 11/21/2025

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