ALBERT M RANDOLPH II

PROVIDENCE HEALTH AND SERVICES - WASHINGTON

Dr ALBERT M RANDOLPH II is a male medical professional, specializing in Family Medicine. He graduated in 1971 from Loma Linda University School Of Medicine.

Contact

PROVIDENCE HEALTH AND SERVICES - WASHINGTON

1111 S 2ND AVE
WALLA WALL
WA
993624118

Tel: 5098975174

ALBERT M RANDOLPH II Information

Npi 1548245400
Pac Id 4587691928
Professional Enrollment Id I20100927001397
Last Name RANDOLPH
First Name ALBERT
Middle Name M
Suffix II
Gender M
Credential
Medical School Name LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 1971
Primary Specialty FAMILY MEDICINE
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name PROVIDENCE HEALTH AND SERVICES - WASHINGTON
Group Practice Pac Id 2860552973
Number Of Group Practice Members 146
Line 1 Street Address 1111 S 2ND AVE
Line 2 Street Address
Marker Of Address Line 2 Suppression
City WALLA WALL
State WA
Zip Code 993624118
Phone Number 5098975174
Hospital Affiliation Ccn 1 500002
Hospital Affiliation Lbn 1 PROVIDENCE ST MARY MEDICAL CENTER
Hospital Affiliation Ccn 2 381319
Hospital Affiliation Lbn 2 ST ANTHONY HOSPITAL
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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