Provider Demographics
NPI:1508857525
Name:WEBB, RANDALL M (MDQ)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:M
Last Name:WEBB
Suffix:
Gender:M
Credentials:MDQ
Other - Prefix:
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Mailing Address - Street 1:699 CHURCH ST NE STE 500
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1131
Mailing Address - Country:US
Mailing Address - Phone:770-424-7100
Mailing Address - Fax:770-514-8493
Practice Address - Street 1:699 CHURCH ST NE STE 500
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1131
Practice Address - Country:US
Practice Address - Phone:770-424-7100
Practice Address - Fax:770-514-8493
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA025846207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology