Mr Gregory W Randolph, MD in Pass Christian, MS - Medicare General Practice

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.

Contact Information

	Mr Gregory W Randolph, MD
	130 Fleitas Ave, Pass Christian, MS 39571-4507
	(228) 452-4888
	(228) 452-5006

Physician's Profile

Full Name	Mr Gregory W Randolph
Gender	Male
Speciality	General Practice
Location	130 Fleitas Ave, Pass Christian, Mississippi
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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Mr Gregory W Randolph, MD - Medicare General Practice in Pass Christian, MS