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Organization

ROYAL RANDOLPH, JR., M.D., M.P.H., LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROYAL RANDOLPH JR. M.D. (OWNER/MEMBER)
(808) 244-9677
Entity
Organization

Contact information

Practice address
2200 MAIN ST, SUITE 517, WAILUKU, HI 96793-1681
(808) 244-9677
(808) 244-9677
Mailing address
PO BOX 1441, WAILUKU, HI 96793-6441
(808) 244-9677
(808) 242-4805

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD-4946
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017302-01
HI
01
1853-1
HMSA
HI
01
192779
HMA, INC HAWAII
HI
01
A-48199
KAISER AFFILIATED CARE
HI
Enumeration date
05/26/2006
Last updated
08/22/2020
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