Provider Demographics
NPI:1750372751
Name:TOWNE, RANDALL D (MD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:D
Last Name:TOWNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1298
Mailing Address - Street 2:
Mailing Address - City:TALBOTT
Mailing Address - State:TN
Mailing Address - Zip Code:37877-1298
Mailing Address - Country:US
Mailing Address - Phone:423-585-5567
Mailing Address - Fax:423-585-4669
Practice Address - Street 1:735 MCFARLAND ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3977
Practice Address - Country:US
Practice Address - Phone:423-585-5567
Practice Address - Fax:423-585-4669
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20016207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3860477Medicaid
TN103I066512Medicare PIN
P00841512Medicare PIN
TN103I060807Medicare PIN
KY0644805Medicare PIN
TN3860477Medicaid
TN3046561Medicare PIN
60027948Medicare PIN
KYP400017546Medicare PIN