# RANDOLPH-MACON COLLEGE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Randolph-Macon College Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376231381
- **Authorized official:** HEATHER LYNN BAUBY LAT (OFFICE DIRECTOR)
- **Authorized official phone:** (804) 752-3215

## Contact information

- **Practice address:** 304 HENRY ST, ASHLAND, VA 23005-1647
- **Practice address phone:** (804) 752-3215
- **Mailing address:** 304 HENRY ST, ASHLAND, VA 23005-1647
- **Mailing address phone:** (804) 752-3215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2255A2300X | Athletic Trainer | — | NULL | — |
| 2255A2300X | Athletic Trainer | — | — | — |

## Other

- **Enumeration date:** 04/27/2023
- **Last updated:** 04/27/2023