person
Dr. Randolph Harlen Robertson, MD
Diagnostic Radiology Physician in Fort Wayne, Indiana
NPI 1164448239

Randolph Harlen Robertson is a Diagnostic Radiology Physician based in Cookeville, IN and is specialized in Diagnostic Radiology. Randolph Harlen Robertson practices in Fort Wayne, IN and has the professional credentials of MD. The NPI Number for Randolph Harlen Robertson is 1164448239 and holds a License No. 18129 (Indiana).

The current practice location address for Randolph Harlen Robertson is 6119 W Jefferson Blvd, Fort Wayne, IN and can be reached out via phone at 260-432-1568 and via fax at 260-432-4969.

Location: 6119 W Jefferson Blvd, Fort Wayne, IN, 38501-1760
person
Provider Profile Details
NPI Number
1164448239
Provider Name
Randolph Harlen Robertson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6119 W Jefferson Blvd, Fort Wayne, IN, 38501-1760
Phone Number
260-432-1568
Fax Number
260-432-4969
Provider Enumeration Date
07/14/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0050269 05 OH
300114288 01 TN RAILROAD MEDICARE
3037577 05 TN
3156107 01 TN BCBS
201023920 05 IN
institution
Provider Business Practice Location Address Details
Address
6119 W Jefferson Blvd
City
State
Zip
46804-3072
Phone Number
260-432-1568
Fax Number
260-432-4969
person
Provider Business Mailing Address Details
Address
6119 W Jefferson Blvd
City
State
Zip
46804-3072
Phone Number
260-432-1568
Fax Number
260-432-4969
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
18129 (Tennessee)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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