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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. BRYAN WAYNE RANDOLPH, D.P.M.

Active

DR. BRYAN WAYNE RANDOLPH, D.P.M. is a Podiatrist healthcare provider located in SHREVEPORT, Louisiana. NPI 1649276007 is currently active in the NPPES registry. Verify at CMS.

Podiatrist · SHREVEPORT, LA

Registration Details

NPI Number
1649276007
Provider Type
Individual
Gender
Male
NPI Issued
Jun 21, 2005 (21.124151922755 yrs)
Last Updated
Jun 17, 2025
Licenses
PD290R (LA)
DPM.PD290R (LA)

Practice Information

Address
1449 E BERT KOUN LOOP STE 101
SHREVEPORT, LA, 711055663
Browse LA providers · Browse ZIP 71105
Phone
3186814282
Primary Specialty
Podiatrist
213E00000X
Additional Specialty
Podiatrist

Other Podiatrist Providers in SHREVEPORT, LA

Name Credential NPI
DR. JERRY ELBERT TOUPS JR. D.P.M 1922004381
DR. DALE CARLTON FAZIO D.P.M. 1194723577
DR. CASSELL HUDSON DPM 1982698023
STEPHEN EUGENE ERTZ DPM 1356321681
MR. ANGELO PAUL MORREALE DPM 1447214143
DR. RICHARD TAYLOR HAVENS DPM 1285643908
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.