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Contact Information

SHELBY J RANDALL, DO
1459 LANEY WALKER BLVD
AUGUSTA, GA30912-0002
 Phone: 916-626-2206
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
 

Medical Toxicology

207PT0002X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SHELBY J RANDALL · (Female)

NPI # 1851954424
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/18/2019
Last updated 10/17/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CA License # 20A20015
  • GA License # 10796
  • GA Medicaid 10796
Hospital affiliation(s)
  • BURKE MEDICAL CENTER - (Acute Care)
    351 LIBERTY STREET
    WAYNESBORO, GA 30830
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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