Organization
JOHN RANDOLPH FAMILY PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SMITH (VP)
(804) 414-0300
Entity
Organization
Contact information
Practice address
12900 JEFFERSON DAVIS HWY, CHESTER, VA 23831-5311
(804) 414-0300
Mailing address
12900 JEFFERSON DAVIS HWY, CHESTER, VA 23831-5311
(804) 414-0300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/29/2006
Last updated
08/22/2020
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