Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RANDAL BLAKE, PA-C, MPAS
ActiveRANDAL BLAKE, PA-C, MPAS is a Medical Physician Assistant healthcare provider located in FORT BRAGG, North Carolina. NPI 1598479370 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · FORT BRAGG, NC
Registration Details
- NPI Number
- 1598479370
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 6, 2023 (3.6149857288655 yrs)
- Last Updated
- Dec 2, 2025
- Licenses
-
15984793701204584
Practice Information
- Address
-
2817 ROCK MERRITT AVEFORT BRAGG, NC, 283104504Browse NC providers · Browse ZIP 28310
- Phone
- 9109078922
- Fax
- 9109076069
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Medical Physician Assistant
Other Medical Physician Assistant Providers in FORT BRAGG, NC
| Name | Credential | NPI |
|---|---|---|
| CHRISTOPHER BRITT DOMINGUEZ | PA-C | 1851384770 |
| MRS. ERIN NICOLE TRENT | PA-C | 1053301069 |
| GERALD DOUGLAS DEPOLD | — | 1245217900 |
| MR. JERRY LYNN JOHNSTON | PA-C | 1609849835 |
| MR. CHARLES MANSON WYATT | PA-C | 1063481018 |
| MR. ROBERT JAMES OYLER | PA-C | 1679542955 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.