Individual
MS. KATE JOANNA RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
751 SAPPINGTON BRIDGE RD, DEPT RADIOLOGY, SULLIVAN, MO 63080-2354
(314) 996-5170
(314) 653-5832
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 996-5170
(314) 653-5832
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2025000294
MO
Other
Enumeration date
10/16/2024
Last updated
11/03/2025
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