Individual
MR. RANDALL SCOTT BURCHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSSW LCSW
Contact information
Practice address
3201 W KEISER, OSCEOLA, AR 72370-3467
(870) 622-0592
(870) 622-0782
Mailing address
1815 PLEASANT GROVE RD, JONESBORO, AR 72405-7870
(870) 933-6886
(870) 933-9395
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1055-C
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227809719
—
AR
01
—
50461
BCBS
AR
Enumeration date
06/24/2014
Last updated
12/08/2022
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