Randolph, Donna W

Randolph, Donna W is an individual health care provider with primary practice located at 1726 Poplar Ave , Memphis TN 38104-6426. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Randolph, Donna W can be contacted via phone (901) 274-3550.

Contact Information

Primary practice address
1726 Poplar Ave Memphis TN 38104-6426
Phone: (901) 274-3550
Fax: (901) 274-3551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD24938 Tennessee

Profile Details

NPI number 1861484594
LBN Legal business name Randolph, Donna W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2005
Last updated May 11th, 2015 - about 9 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 1861484594 NPPES
Tennessee MEDICAID 3373068
Tennessee MEDICAID 3093788
Tennessee MEDICAID 3099789
Tennessee Other 103I165972

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