Individual
BRUCE WENDELL RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MEDICAL DOCTOR
Contact information
Practice address
3960 KNIGHT ARNOLD RD, SUITE 103, MEMPHIS, TN 38118
(901) 547-1911
(901) 547-1905
Mailing address
3960 KNIGHT ARNOLD RD, SUITE 103, MEMPHIS, TN 38118
(901) 547-1911
(901) 547-1905
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
10835
MS
2083X0100X
Occupational Medicine Physician
16897
OK
2083X0100X
Occupational Medicine Physician
Primary
27686
TN
Other
Enumeration date
11/27/2006
Last updated
07/08/2007
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