Individual
DR. JAMES G RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
151 S 6THST, WORLAND, WY 82401-3339
(307) 347-8262
(307) 347-8265
Mailing address
PO BOX 463, WORLAND, WY 82401-0463
(307) 347-8262
(307) 347-8265
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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