Holloway, Randall

Holloway, Randall is an sole proprietor health care provider with primary practice located at 4 S National Ave , Fort Scott KS 66701-1309. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Holloway, Randall can be contacted via phone (620) 223-0850.

Contact Information

Primary practice address
4 S National Ave Fort Scott KS 66701-1309
Phone: (620) 223-0850
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1184-3 Kansas

Profile Details

NPI number 1134221864
LBN Legal business name Holloway, Randall
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 2nd, 2006
Last updated Jan 5th, 2012 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1134221864 NPPES
Kansas MEDICAID 100217910A
Kansas Other 410008912

Popular Providers