| Bernard C Randolph Jr, MD | |
|
12855 North Forty Drive, Suite 125, St Louis, MO 63141 | |
| (314) 966-0111 | |
| (314) 966-1023 |
| Full Name | Bernard C Randolph Jr |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 41 Years |
| Location | 12855 North Forty Drive, St Louis, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841286358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | R6G60 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Hospital St Louis | Saint louis, MO | Hospital |
| Mercy Hospital South | Saint louis, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Physical Therapy Spine And Sports Medicine Llc | 3173654936 | 100 |
| Mercy Clinic East Communities | 7214827922 | 535 |
| Entity Name | Mercy Clinic East Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851335228 PECOS PAC ID: 7214827922 Enrollment ID: O20070521000006 |
| Mailing Address | Practice Location Address |
|---|---|
| Bernard C Randolph Jr, MD 12813 Flushing Meadows Drive, Suite 210, St. Louis, MO 63131 Ph: (314) 966-0111 | Bernard C Randolph Jr, MD 12855 North Forty Drive, Suite 125, St Louis, MO 63141 Ph: (314) 966-0111 |
Dr. Anthony J Margherita, MD Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 555 North New Ballas Rd, Suite 210, St Louis, MO 63141 Phone: 314-432-4999 Fax: 314-432-5088 | |
Sandra L Tate, MD Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 12855 North Forty Drive, Suite 125, St Louis, MO 63141 Phone: 314-966-0111 Fax: 314-966-1023 |