Provider Demographics
NPI:1518144732
Name:STINSON, RANDALL K (PA)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:K
Last Name:STINSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30560-0540
Mailing Address - Country:US
Mailing Address - Phone:706-374-6898
Mailing Address - Fax:706-374-5006
Practice Address - Street 1:1008 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:GA
Practice Address - Zip Code:30705-2118
Practice Address - Country:US
Practice Address - Phone:706-517-2273
Practice Address - Fax:706-517-2469
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2008-01-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical