Provider Demographics
NPI:1386219335
Name:RANDOLPH, OPAL ERIKA (DO)
Entity type:Individual
Prefix:DR
First Name:OPAL
Middle Name:ERIKA
Last Name:RANDOLPH
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1040 W BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-5516
Mailing Address - Country:US
Mailing Address - Phone:810-257-3709
Mailing Address - Fax:810-257-3755
Practice Address - Street 1:1040 W BRISTOL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-5516
Practice Address - Country:US
Practice Address - Phone:810-257-3709
Practice Address - Fax:810-257-3755
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2025-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI51010282932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry