Individual
RANDELL LEON ELKINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
701 BROAD ST STE 350, ROME, GA 30161-3092
(706) 295-2028
(706) 295-2062
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY000948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000493083B
—
GA
Enumeration date
12/09/2006
Last updated
06/30/2020
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