Individual
DR. RANDOLPH PHILIP ROUNTREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PSY.D.
Contact information
Practice address
1505 S DON ROSER DR STE A, LAS CRUCES, NM 88011-4596
(719) 238-9111
Mailing address
PO BOX 2005, WOODLAND PARK, CO 80866-2005
(719) 238-9111
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3689
CO
103TP0016X
Prescribing (Medical) Psychologist
Primary
C0076
NM
Other
Enumeration date
12/15/2011
Last updated
12/20/2019
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