| Randle T. Middleton Md, P.c | |
|
2089 Cecil Ashburn Dr Se Suite 101 Huntsville AL 35802-2567 | |
| (256) 882-7351 | |
| (256) 489-2322 |
| Full Name | Randle T. Middleton Md, P.c |
|---|---|
| Speciality | Family Medicine |
| Location | 2089 Cecil Ashburn Dr Se, Huntsville, Alabama |
| Authorized Official Name and Position | Randle Thomas Middlton (OWNER) |
| Authorized Official Contact | 2568827351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randle T. Middleton Md, P.c 2089 Cecil Ashburn Dr Se Suite 101 Huntsville AL 35802-2567 Ph: (256) 882-7351 | Randle T. Middleton Md, P.c 2089 Cecil Ashburn Dr Se Suite 101 Huntsville AL 35802-2567 Ph: (256) 882-7351 |
| NPI Number | 1033356373 |
|---|---|
| Provider Enumeration Date | 01/08/2009 |
| Last Update Date | 11/09/2012 |
| Medicare PECOS PAC ID | 8820151186 |
|---|---|
| Medicare Enrollment ID | O20090113000183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033356373 | NPI | - | NPPES |
| 000038324 | Other | AL | MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 18862 (Alabama) | Primary |
| Provider Name | Randle T Middleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801845920 PECOS PAC ID: 0648280669 Enrollment ID: I20090113000170 |
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