MEDICARE: MR. RANDOLPH EVAN BELCHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	HADS000748	GA

General Provider Information

NPI Number	:	1194334227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RANDOLPH EVAN BELCHER

Provider Business Mailing Address
First Line	:	3907 MACON RD STE F
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-2292
Country	:	US
Telephone Number	:	706-221-8006
Fax Number	:

Provider Business Practice Location Address
First Line	:	3907 MACON RD STE F
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-2292
Country	:	US
Telephone Number	:	706-221-8006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2020
Last Update Date	:	04/30/2024

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