| Organization Name: | MICHAEL C. RANDON, MD |
| NPI Number: | 1194916627 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL C. RANDON (SOLE PROPRIETOR) |
| Mailing Address: | 23 Isaac St Middleboro |
| State: | MA US |
| Postal Code: | 023462080 |
| Phone Number: | 5089479295 |
| Fax Number: | 5089477974 |
| NPI Enumeration Date: | 08/08/2007 |
| NPI Last Update Date: | 09/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |