| Dr Jacquetta Taisha Randall, MD | |
|
451 Ruin Creek Rd, Suite 101, Henderson, NC 27536-2878 | |
| (252) 492-9565 | |
| Not Available |
| Full Name | Dr Jacquetta Taisha Randall |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 451 Ruin Creek Rd, Henderson, North Carolina |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588982466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | A111970 (California) | Secondary |
| 208000000X | Pediatrics | 2012-01956 (North Carolina) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jacquetta Taisha Randall, MD 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536-2878 Ph: (252) 492-9565 | Dr Jacquetta Taisha Randall, MD 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536-2878 Ph: (252) 492-9565 |
Dr. Cornelius F Cathcart, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536 Phone: 252-492-9565 Fax: 252-492-5373 | |
Eureka Llowanna Phillip, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 451 Ruin Creek Rd Ste 101, Henderson, NC 27536 Phone: 252-492-9565 Fax: 252-492-5373 | |
Dr. Nicole Saint Simone Beaufort, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 451 Ruin Creek Rd, Suite 101, Henderson, NC 27536 Phone: 919-492-9565 Fax: 919-492-5373 | |
Dr. Laura Patricia Diefendorf, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 480 Ruin Creek Rd, Henderson Family Medicine Clinic, Henderson, NC 27536 Phone: 252-492-3152 Fax: 252-430-1928 |