Henry, Larry Randall

Henry, Larry Randall is an individual health care provider with primary practice located at 14701 N Santa Fe Ave , Edmond OK 73013-3411. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Henry, Larry Randall can be contacted via phone (405) 752-2733.

Contact Information

Primary practice address
14701 N Santa Fe Ave Edmond OK 73013-3411
Phone: (405) 752-2733
Fax: (405) 752-2172
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2040 Oklahoma

Profile Details

NPI number 1932102894
LBN Legal business name Henry, Larry Randall
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated May 8th, 2008 - about 16 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 1932102894 NPPES
Oklahoma Other 4628540 AETNA
Oklahoma Other 1677321 AETNA
Oklahoma MEDICAID 100765720A AETNA

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