Individual
RANDOLPH P SUMNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 290-9222
(706) 290-0045
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
028323
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000320955A
—
GA
05
—
000320955E
—
GA
05
—
000320955F
—
GA
05
—
000320955G
—
GA
Enumeration date
09/19/2005
Last updated
05/05/2020
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