Provider Demographics
NPI:1679672406
Name:MCCAFFERTY, RANDALL ROBERT (MD)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:ROBERT
Last Name:MCCAFFERTY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1814 WESTCHESTER DR STE 401
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7369
Mailing Address - Country:US
Mailing Address - Phone:336-802-2080
Mailing Address - Fax:336-802-2081
Practice Address - Street 1:1814 WESTCHESTER DR STE 401
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7369
Practice Address - Country:US
Practice Address - Phone:336-802-2080
Practice Address - Fax:336-802-2081
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE 81608207T00000X
CAG81608207T00000X
TXM5365207T00000X
OH35-079331207T00000X
NC2002-00140207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery