Doctor Name: | DR. ROYAL RANDOLPH |
NPI Number: | 1881725414 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD 4946 |
Business Practice Address: | 2200 Main St Suite 517 Wailuku, HI - 967931654 |
Business Phone Number: | 8082449677 |
Business Fax Number: | 8082424805 |
Mailing Address: | Po Box 1441, WAILUKU |
State: | HI |
Postal Code: | 967936441 |
Phone Number: | 8082449677 |
Fax Number: | 8082424805 |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 10/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | MD 4946 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |