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1952394629
MARK PATRICK RANDOLPH
WILSON, NC
NPI
1952394629
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NC 103783)
Enumeration Date
2005-08-26
Last Update Date
2020-12-08
Business Address
MARK PATRICK RANDOLPH PA-C
2503 WOOTEN BLVD SW
WILSON, NC 27893-4426
Phone number: 252-243-2268
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Mailing Address
MARK PATRICK RANDOLPH PA-C
PO BOX 3127
WILSON, NC 27895-3127
Phone number: 252-243-2268
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