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General NPI Number Information
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NPI Number | 1114086824
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Entity Type | Organization
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Legal Business Name | RANDOLPH WOMENS HEALTH CARE, PC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 12/27/2012
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Provider Practice Location Address
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Address Line | 311 E PRESNELL ST
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City | ASHEBORO
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State | NC
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Zip | 27203-4744
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Country | US
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Telephone | 336-626-0550
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Fax | 336-626-0650
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Provider Business Mailing Address
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Address Line | 311 EAST PRESNELL STREET
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City | ASHEBORO
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State | NC
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Zip | 27203-4744
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Country | US
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Telephone | 336-626-0550
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Fax | 336-626-0650
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIM C BROOKS
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Credential | MD
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Telephone | 336-626-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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