Most Relevant Information
Provider Data
| NPI Number: | 1003203027 |
| Provider Name: | RANDOLPH COLBERT |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/16/2015 |
| Last Updated: | 04/16/2015 |
Provider Practice Location
202 W ATLANTA ST STE C
OKEMAH
OK
748592633
Practice Location Phone/Fax
| Phone: | 9186233010 |
| Fax: |
Provider Mailing Location
108147 N 3800 RD
OKEMAH
OK
748593302
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |