Individual
DR. RANDOLPH HARLEN ROBERTSON
Active
Individual
DR. RANDOLPH HARLEN ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18129
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050269
—
OH
05
—
201023920
—
IN
01
—
300114288
RAILROAD MEDICARE
TN
05
—
3037577
—
TN
01
—
3156107
BCBS
TN
Enumeration date
07/14/2006
Last updated
02/15/2016
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