| Royal Randolph, Jr., M.d., M.p.h., Llc | |
|
2200 Main St Suite 517 Wailuku HI 96793-1681 | |
| (808) 244-9677 | |
| (808) 244-9677 |
| Full Name | Royal Randolph, Jr., M.d., M.p.h., Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2200 Main St, Wailuku, Hawaii |
| Authorized Official Name and Position | Royal Randolph (OWNER/MEMBER) |
| Authorized Official Contact | 8082449677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Royal Randolph, Jr., M.d., M.p.h., Llc Po Box 1441 Wailuku HI 96793-6441 Ph: (808) 244-9677 | Royal Randolph, Jr., M.d., M.p.h., Llc 2200 Main St Suite 517 Wailuku HI 96793-1681 Ph: (808) 244-9677 |
| NPI Number | 1245286780 |
|---|---|
| Provider Enumeration Date | 05/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245286780 | NPI | - | NPPES |
| 017302-01 | Medicaid | HI | |
| 192779 | Other | HI | HMA, INC HAWAII |
| 192779 | Other | HI | HAWAII ELECTRICIANS HEALT |
| 1853-1 | Other | HI | HMSA |
| 192779 | Other | HI | SUMMERLIN LIFE & HEALTH |
| A-48199 | Other | HI | KAISER AFFILIATED CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD-4946 (Hawaii) | Primary |
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