Healthcare Provider Details

I. General information

NPI: 1487560751
Provider Name (Legal Business Name): RANDALL ENGLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 ALABAMA AVE SW
FORT PAYNE AL
35967-1953
US

IV. Provider business mailing address

204 ALABAMA AVE SW
FORT PAYNE AL
35967-1953
US

V. Phone/Fax

Practice location:
  • Phone: 256-979-1777
  • Fax: 855-395-0843
Mailing address:
  • Phone: 256-979-1777
  • Fax: 855-395-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: