Individual
DR. JOHN JAMES RANDOLPH
Active
Individual
DR. JOHN JAMES RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1027
NH
103T00000X
Psychologist
1027
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00068596
BLUE CROSS BLUE SHIELD
VT
01
—
06Y007347NH01
ANTHEM BLUE CROSS BLUE SH
NH
Enumeration date
06/17/2005
Last updated
03/04/2014
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