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Organization
RANDOLPH SPECIALTY GROUP PRACTICE
Active
Organization
RANDOLPH SPECIALTY GROUP PRACTICE
Active
Other names
Randolph Health Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SCOTT CLAUSER (EXECUTIVE DIRECTOR)
(336) 625-2333
Entity
Organization
Contact information
Practice address
525 W SWANNANOA AVE, LIBERTY, NC 27298-3136
(336) 622-4850
(336) 622-4855
Mailing address
PO BOX 5418, ASHEBORO, NC 27204-5418
(336) 625-2333
(336) 625-5511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0248R
BCBS
NC
05
—
5900588
—
NC
Enumeration date
02/20/2008
Last updated
02/24/2020
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