Individual
RICHARD RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1094 RIVER ISLE DR, MEMPHIS, TN 38103-8870
(912) 667-0714
Mailing address
1094 RIVER ISLE DR, MEMPHIS, TN 38103-8870
(912) 667-0714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2834
TN
Other
Enumeration date
10/27/2015
Last updated
10/27/2015
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