Individual
MR. JAMES PAUL RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1960 COMMERCIAL ST SE, SALEM, OR 97302-5206
(503) 363-9011
(503) 362-6376
Mailing address
1960 COMMERCIAL ST SE, SALEM, OR 97302-5206
(503) 363-9011
(503) 362-6376
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1453 ATI ACTIVE
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163352
—
OR
Enumeration date
05/01/2007
Last updated
07/08/2007
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