Provider Demographics
NPI:1396039020
Name:RANDALL, LAUREN HALL (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:HALL
Last Name:RANDALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:BLAIR
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5505 PEACHTREE DUNWOODY RD STE 650
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1755
Mailing Address - Country:US
Mailing Address - Phone:404-459-9340
Mailing Address - Fax:404-459-9347
Practice Address - Street 1:5505 PEACHTREE DUNWOODY RD STE 650
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1755
Practice Address - Country:US
Practice Address - Phone:404-459-9340
Practice Address - Fax:404-459-9347
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA071159207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine