RANDY D. PROFFITT, M.D., LLC (NPI# 1326066010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326066010 |
Entity Type | Organization |
Organization Name | RANDY D. PROFFITT, M.D., LLC |
Practice Address |
6317 Piccadilly Square Dr Mobile AL 36609-5103 |
Practice Telephone | 2513440322 |
Practice Fax Number | 2513440395 |
Mailing Telephone | 2513440322 |
Mailing Fax Number | 2513440395 |
Enumeration Date | 2006-07-18 |
Last Update Date | 2015-01-27 |
Authorized Official Name | RANDY D PROFFITT (PRESIDENT) |
Authorized Official Telephone | 2516070300 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AL | BLUE CROSS | 51531824 | 01 |
AL | 051531824 | 05 |
Street Address |
6317 PICCADILLY SQUARE DR |
City | MOBILE |
State | AL |
Zip Code | 36609-5103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821698309 | Bhg Lxxii, LLC | Clinic/Center | 4373 Dowtowner Loop South, Suite A, Mobile, AL 36609 | 2020-10-26 |
1760036008 | Jesse David Schultz | Chiropractor | 3501 Montlimar Plaza Drive, Mobile, AL 36609 | 2019-07-25 |
1982267241 | Raqueal L. Williams | Registered Nurse | 406 Larose Dr., Mobile, AL 36609 | 2019-04-22 |
1588131924 | Angela Roney | Counselor | 705 Oak Circle Dr. East, Mobile, AL 36609 | 2018-10-24 |
1134617996 | Harley Michelle Oliver | Physician Assistant | 820 S. University Blvd Bldg 1, Suite 1b, Mobile, AL 36609 | 2018-04-27 |
1912420126 | Rural Urgent Care LLC | Clinic/Center | 6280 Grelot Road, Mobile, AL 36609 | 2017-07-19 |
1598128407 | Trisha Mcmillon | Counselor | 3929 Airport Blvd Ste 1-214, Mobile, AL 36609 | 2016-03-30 |
1437523347 | Sonya White D.d.s. PC | Dentist | 6309 Piccadilly Square Dr., Mobile, AL 36609 | 2015-11-17 |
1386913374 | Janis Marie Fausser | Pharmacist | 5705 Cottagehill Rd, Mobile, AL 36609 | 2011-12-20 |
1245524263 | Emily Chisholm | Physical Therapist | 1515 University Blvd. S., Mobile, AL 36609 | 2011-06-07 |
Find all providers in zip 36609 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528085347 | Randy Douglas Proffitt | Surgery | 740 Hillcrest Rd, Suite C, Mobile, AL 36695-3924 | 2006-07-16 |
1871531681 | Curtis N Harris | Surgery | 1601, Ste 2n, Mobile, AL 36604-1512 | 2006-06-03 |
1346808508 | Usa Health Physician Billing Services LLC | Surgery | 1601 Center St, Mobile, AL 36604-1541 | 2019-06-03 |
1134488679 | Kelsey Catherine Ringel Mckee | Surgery | 1601 Center St, Mobile, AL 36604-1541 | 2012-05-03 |
1356538961 | Kitti K. Outlaw, M.d., P.C. | Surgery | 3715 Dauphin St Ste 6a, Mobile, AL 36608-1774 | 2007-09-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780056945 | Melanie Petro Md LLC | Surgery | 905 Moontgomery Highway, Birmingham, AL 35216 | 2015-10-28 |
1316100670 | Patrick C Wilson | Surgery | 805 Madison St., Suite 1d, Huntsville, AL 35801 | 2008-07-08 |
1366629917 | Jeffery L Walding | Surgery | 2800 Ross Clark Cir Ste 2, Dothan, AL 36301-9917 | 2008-01-25 |
1639372725 | Justin Parish Martin | Surgery | 2431 W Main St Ste 302, Dothan, AL 36301-1251 | 2007-06-07 |
1245456805 | Michael D. Yates, Md, PC | Surgery | 303 Williams Av Sw, Suite 1421, Huntsville, AL 35801-6008 | 2007-04-18 |
1114062106 | Luther Dwight Baker | Surgery | 105 Professional Ln, Dothan, AL 36303-3875 | 2007-02-20 |
1932267218 | Gordon Michael Telepun | Surgery | 1206 Somerville Rd Se, Decatur, AL 35601 | 2006-12-05 |
1316014681 | Plastic Surgery Inc | Surgery | 701 University Blvd Medical Tower, Suite 902, Tuscaloosa, AL 35401 | 2006-11-29 |
1538122080 | David L. Durst | Surgery | 4011 Balmoral Dr Sw, Huntsville, AL 35801-6403 | 2006-04-07 |
1154743573 | Tuesday M Bigelow | Surgery | 1202 S Broad St, Scottsboro, AL 35768-2516 | 2014-01-21 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.