Theodore John Randolph is a Port Jefferson Station, New York based male podiatrist who is specialized in Podiatric Foot & Ankle Surgery. Active license number of Theodore John Randolph for Podiatric Foot & Ankle Surgery is 003646 in New York. Theodore John Randolph provide comprehensive medical and surgical care for a wide spectrum of foot and ankle conditions, including common to complex disorders and injuries that affect people of all ages. He is uniquely qualified to detect the early stages of diseases that exhibit warning signs in the lower extremities, such as diabetes, arthritis and cardiovascular disease, and can manage foot conditions that may pose an ongoing threat to a patient’s overall health.
Complete Profile:
Theodore John Randolph speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Podiatrist - Foot & Ankle Surgery
Credentials:
D.P.M
Gender:
Male
Practice Address:
3 Medical Dr, Suite C, Port Jefferson Station, New York, 11776-1597
Phone:
631-928-7785
Fax:
631-928-0316
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1831197318
NPI Enumeration Date:
08 Jul, 2005
NPI Last Update On:
20 Oct, 2011
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Theodore John Randolph are as mentioned below.
License Number
Specialization
State
Status
003646
Podiatric Foot & Ankle Surgery
New York
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Theodore John Randolph such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
791048
Medicaid
New York
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
3 Medical Dr, Suite C Port Jefferson Station, New York
Zip:
11776-1597
Phone Number:
631-928-7785
Fax Number:
631-928-0316
Patients can reach Theodore John Randolph at 3 Medical Dr, Suite C, Port Jefferson Station, New York or can call to book an appointment on 631-928-7785. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 October, 2024.
Comments/ Reviews:
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