| Dr Derrick Wade Randall, MD | |
|
2145 Henry Tecklenburg Dr Ste 220, Charleston, SC 29414-5894 | |
| (843) 723-8823 | |
| (843) 606-8059 |
| Full Name | Dr Derrick Wade Randall |
|---|---|
| Gender | Male |
| Speciality | Pain Management |
| Experience | 30 Years |
| Location | 2145 Henry Tecklenburg Dr Ste 220, Charleston, South Carolina |
| 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 |
|---|---|---|---|
| 1699766758 | NPI | - | NPPES |
| 19659 | Other | SC | SC LICENSE |
| 196594 | Medicaid | SC | |
| 000915967B | Medicaid | GA |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bon Secours-st Francis Xavier Hospital | Charleston, SC | Hospital |
| Roper Hospital | Charleston, SC | Hospital |
| Musc Medical Center | Charleston, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Roper Saint Francis Physicians Network | 5193874824 | 478 |
| Entity Name | Roper Saint Francis Physicians Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124431606 PECOS PAC ID: 5193874824 Enrollment ID: O20090528000405 |
| Entity Name | Medstream Anesthesia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649616160 PECOS PAC ID: 7416198049 Enrollment ID: O20140304001021 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Derrick Wade Randall, MD Po Box 751649, Charlotte, NC 28275-1649 Ph: (888) 472-0043 | Dr Derrick Wade Randall, MD 2145 Henry Tecklenburg Dr Ste 220, Charleston, SC 29414-5894 Ph: (843) 723-8823 |
Dr. George M Inabinet Jr., MD Pain Medicine Medicare: Medicare Enrolled Practice Location: 171 Ashley Ave, Charleston, SC 29425 Phone: 843-792-1414 | |
Dr. Dale Raymond Tabor, M.D. Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 109 Bee St, Va Anesthesia Service, Charleston, SC 29401 Phone: 843-789-7345 | |
Jeffrey W Folk, Pain Medicine Medicare: Medicare Enrolled Practice Location: 125 Doughty St, Ste 420, Charleston, SC 29403 Phone: 843-723-3441 Fax: 843-805-4040 | |
Todd P Joye, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 125 Doughty St, Ste 420, Charleston, SC 29403 Phone: 843-723-3441 Fax: 843-805-4040 |