Organization
RANDALL D WOLCOTT MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH KAY RASK (BILLING SUPERVISOR)
(806) 793-8869
Entity
Organization
Contact information
Practice address
2002 OXFORD AVE, LUBBOCK, TX 79410-1025
(806) 793-8869
(806) 793-0043
Mailing address
2002 OXFORD AVE, LUBBOCK, TX 79410-1025
(806) 793-8869
(806) 793-0043
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G6248
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB9128
RAILROAD MEDICARE
—
05
—
W7688
—
NM
Enumeration date
09/21/2006
Last updated
11/16/2007
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