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1164448239
RANDOLPH HARLEN ROBERTSON
FORT WAYNE, IN
NPI
1164448239
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: TN 18129)
Enumeration Date
2006-07-14
Last Update Date
2016-02-15
Business Address
Dr. RANDOLPH HARLEN ROBERTSON MD
6119 W JEFFERSON BLVD
FORT WAYNE, IN 46804-3072
Phone number: 260-432-1568
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Mailing Address
Dr. RANDOLPH HARLEN ROBERTSON MD
142 W 5TH ST
COOKEVILLE, TN 38501-1760
Phone number: 931-528-2541
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