Godwin, Randy W.

Godwin, Randy W. is an individual health care provider with primary practice located at 1233 N Brightleaf Blvd , Smithfield NC 27577-4229. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Godwin, Randy W. can be contacted via phone (919) 934-1272.

Contact Information

Primary practice address
1233 N Brightleaf Blvd Smithfield NC 27577-4229
Phone: (919) 934-1272
Fax: (919) 934-1273
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 1508 North Carolina

Profile Details

NPI number 1962876367
LBN Legal business name Godwin, Randy W.
Credentials DISPENSING OPTICIAN
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2015
Last updated Nov 23rd, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962876367 NPPES
North Carolina MEDICAID 47-5024935

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