Randall T Paul
Individual provider Active NPI Driver · Atoka, TN
NPI 1346960713 · NPPES record last updated Aug 29, 2022
Key facts
- NPI
- 1346960713
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 061377689 (TN)
- Practice address
- 703 Trebing Pkwy
Atoka, TN 38004-7796 - Phone
- (901) 734-1928
- NPI assigned
- Aug 29, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 061377689 | TN | MD | Driver |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardinal Transport LLC | Current |
Accepting new patients | |
| Cardinal Transport LLC | Driver | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 061377689 | TN | Yes |
Addresses
Primary practice location
703 Trebing Pkwy
Atoka, TN 38004-7796
Mailing address
703 Trebing Pkwy
Atoka, TN 38004-7796
Phone (901) 734-1928
Other providers in Atoka, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.