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NPI Code Detail

MEDICARE: RANDALL ALAN RANSOM JR. DPT

MEDICARE: RANDALL ALAN RANSOM JR. DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT010397GA
2225100000XPhysical TherapistPTH6151AL

General Provider Information

NPI Number : 1306124151
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDALL ALAN RANSOM JR. DPT
Provider Business Mailing Address
First Line : 680 S 9TH ST STE A
Second Line :
City : GRIFFIN
State : GA
Zip : 30224-4216
Country : US
Telephone Number : 770-229-6141
Fax Number : 707-229-6142
Provider Business Practice Location Address
First Line : 2515 E GLENN AVE STE 104
Second Line :
City : AUBURN
State : AL
Zip : 36830-6448
Country : US
Telephone Number : 334-821-2256
Fax Number : 334-826-8082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2011
Last Update Date : 04/09/2025

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