Individual
JAMES KEITH RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3404 W SYLVANIA AVE, TOLEDO, OH 43623-4467
(419) 251-1206
Mailing address
2200 JEFFERSON AVE, 4TH FLOOR, TOLEDO, OH 43604-7101
(419) 251-2673
(419) 251-0916
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704229515
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
NA08155
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2541379
—
OH
Enumeration date
09/09/2005
Last updated
12/12/2021
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