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Contact Information

DERRICK W RANDALL, MD
2145 HENRY TECKLENBURG DR STE 220
CHARLESTON, SC29414-5894
 Phone: 843-723-8823
 Fax: 843-606-8059
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for DERRICK W RANDALL · (Male)

NPI Number 1699766758
Status Active
Credentials MD
Entity Individual
Enumeration date 10/28/2005
Last updated 01/15/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • GA License # 050251
  • SC License # 19659
  • GA Medicaid 000915967B
  • SC Medicaid 196594
  • SC Other 19659 SC LICENSE
Hospital affiliation(s)
  • BON SECOURS-ST FRANCIS XAVIER HOSPITAL - (Acute Care)
    2095 HENRY TECKLENBURG DRIVE
    CHARLESTON, SC 29414
  • MOUNT PLEASANT HOSPITAL - (Acute Care)
    3500 HIGHWAY 17 NORTH
    MOUNT PLEASANT, SC 29466
  • ROPER HOSPITAL - (Acute Care)
    316 CALHOUN ST
    CHARLESTON, SC 29401
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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