Mr Gregory W Randolph, MD is a medicare enrolled "General Practice" physician in Pass Christian, Mississippi. His current practice location is
130 Fleitas Ave, Pass Christian, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(228) 452-4888.
Mr Gregory W Randolph is licensed to practice in Mississippi (license number 13081) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1699760652.
Physician's Profile
Full Name | Mr Gregory W Randolph |
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Gender | Male |
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Speciality | General Practice |
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Location | 130 Fleitas Ave, Pass Christian, Mississippi |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699760652
- Provider Enumeration Date: 09/15/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 1557685492
- Enrollment ID: I20150123000998
Medical Identifiers
Medical identifiers for Mr Gregory W Randolph such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699760652 | NPI | - | NPPES |
00117253 | Medicaid | MS | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 13081 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Gregory W Randolph is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Gregory W Randolph, MD 130 Fleitas Ave, Pass Christian, MS 39571-4507 Ph: (228) 452-4888 | Mr Gregory W Randolph, MD 130 Fleitas Ave, Pass Christian, MS 39571-4507 Ph: (228) 452-4888 |
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