Healthcare Provider Details

I. General information

NPI: 1821037383
Provider Name (Legal Business Name): CHARLES RANDOLPH SPEIGHTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1612 HIGHWAY 78 EAST SUITE 100
OXFORD AL
36203-5862
US

IV. Provider business mailing address

PO BOX 117598
ATLANTA GA
30368-7598
US

V. Phone/Fax

Practice location:
  • Phone: 256-835-4756
  • Fax: 256-831-5736
Mailing address:
  • Phone: 770-442-1911
  • Fax: 770-442-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25082
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: