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Individual

DR. RANDOLPH EWING LANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4064 JAMES MADISON HWY, FORK UNION, VA 23055
(434) 842-3244
(434) 842-1110
Mailing address
PO BOX 458, FORK UNION, VA 23055
(434) 842-3244
(434) 842-1110

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101032081
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005615151
VA
Enumeration date
02/26/2007
Last updated
01/19/2010
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