Individual
RANDOLPH LEE JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
403 S BALDWIN STREET, WOODLAND PARK, CO 80863-8762
(719) 686-7776
(719) 355-1927
Mailing address
403 S BALDWIN ST, WOODLAND PARK, CO 80863-3154
(719) 686-7776
(719) 355-1927
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45978
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
811674
MEMORIAL HOSPITAL
CO
Enumeration date
08/31/2005
Last updated
02/03/2012
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