Provider Demographics
NPI:1598062341
Name:COLE, RANDOLPH ROBINSON (MD)
Entity Type:Individual
Prefix:
First Name:RANDOLPH
Middle Name:ROBINSON
Last Name:COLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 STONEWALL HTS
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2923
Mailing Address - Country:US
Mailing Address - Phone:276-623-8356
Mailing Address - Fax:
Practice Address - Street 1:176 VALLEY ST NW
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2836
Practice Address - Country:US
Practice Address - Phone:276-628-9547
Practice Address - Fax:276-628-8221
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049124207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology