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Individual

ERICH GRAHAM RANDOLPH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2406 BELLEVUE RD STE 7, DUBLIN, GA 31021-2842
(478) 272-2255
(478) 278-9134
Mailing address
PO BOX 96465, CHARLOTTE, NC 28296-0465

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
021790
GA
2085R0001X
Radiation Oncology Physician
Primary
021790
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000305951L
GA
05
000305951M
GA
05
000305951N
GA
05
000305951O
GA
05
000305951P
GA
05
000305951Q
GA
05
000305951R
GA
05
000305951S
GA
05
000305951T
GA
01
92BBGBZ
MEDICARE PROVIDER ID
GA
Enumeration date
06/03/2006
Last updated
02/25/2026
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