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General NPI Number Information
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NPI Number | 1891806972
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Entity Type | Organization
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Legal Business Name | RANDOLPH WOMENS CENTER
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 661 S PARKWAY E
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City | MEMPHIS
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State | TN
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Zip | 38106-5617
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Country | US
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Telephone | 901-346-9116
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1000 DEPT. 299
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City | MEMPHIS
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State | TN
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Zip | 38148-5617
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Country | US
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Telephone | 901-346-9116
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Fax |
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | DONNA W RANDOLPH
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Credential | M.D.
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Telephone | 901-346-9116
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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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