Randall T. Mathis, PA-C

Surgical Physician Assistant · St Augustine, FL

Individual Active NPI

NPI number 1922055391

Practice location

100 Whetstone Pl
Ste 310
St Augustine, FL 32086-5774
Phone
(904) 217-7450
Fax
(904) 217-7483

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NPI record

NPI
1922055391
Entity type
Individual (Type 1)
Enumeration date
May 30, 2006
Last updated
April 16, 2012
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Surgical Physician Assistant Primary 363AS0400X PA9101202 FL
Physician Assistant 363A00000X PA9101202 FL

Mailing address

PO Box 3123
St Augustine, FL 32085-3123
Phone
(904) 217-7450
Fax
(904) 217-7483

About Randall Mathis

Randall T. Mathis, PA-C is a healthcare provider registered in the NPI registry with the primary taxonomy Surgical Physician Assistant (code 363AS0400X). The practice location is 100 Whetstone Pl, Ste 310, St Augustine, FL 32086-5774. The NPI number 1922055391 was assigned on May 30, 2006 and the record was last updated on April 16, 2012.

Randall Mathis lists 2 licenses in the registry: #PA9101202 (FL) for Surgical Physician Assistant; #PA9101202 (FL) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Randall T. Mathis, PA-C?

The NPI number is 1922055391.

What is the phone number of Randall Mathis?

The phone number listed for the practice location is (904) 217-7450.

Where is Randall Mathis located?

100 Whetstone Pl, Ste 310, St Augustine, FL 32086-5774.

What is the taxonomy code for Randall Mathis?

The primary taxonomy code is 363AS0400X – Surgical Physician Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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