Individual
DR. JAMES G RANDOLPH
Active
Individual
DR. JAMES G RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5211A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102379900
—
WY
01
—
200016320
RAILROAD MEDICARE
—
01
—
308041
BLUE CROSS BLUE SHIELD
WY
Enumeration date
01/11/2006
Last updated
07/22/2010
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