Randolph, John

Randolph, John is an individual health care provider with primary practice located at 105 Liberty Blvd , Liberty SC 29657-1641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Randolph, John can be contacted via phone (864) 843-8500.

Contact Information

Primary practice address
105 Liberty Blvd Liberty SC 29657-1641
Phone: (864) 843-8500
Fax: (864) 843-5634
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 35074072 Ohio
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 24613 South Carolina

Profile Details

NPI number 1689677882
LBN Legal business name Randolph, John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Oct 14th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689677882 NPPES
Ohio MEDICAID 2141300

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