Individual
DR. RANDY JOSEPH VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6027 WALNUT GROVE, SUITE 317, MEMPHIS, TN 38120-2145
(901) 818-3921
(901) 767-3056
Mailing address
6027 WALNUT GROVE, SUITE 317, MEMPHIS, TN 38120-2145
(901) 818-3921
(901) 767-3056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39777
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3335228
—
TN
Enumeration date
05/16/2006
Last updated
05/29/2015
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