Randle, Eric Dale
Randle, Eric Dale is an individual health care provider with primary practice located at 2708 West Oxford Loop Suite 110, Oxford MS 38655. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Randle, Eric Dale can be contacted via phone (662) 380-5041.Contact Information
Primary practice address
2708 West Oxford Loop Suite 110
Oxford MS 38655
Phone: (662) 380-5041
Fax: (662) 380-5042
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 687P-Y | Mississippi |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 687 | Mississippi |
Profile Details
| NPI number | 1336247816 |
|---|---|
| LBN Legal business name | Randle, Eric Dale |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Feb 10th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336247816 | NPPES |
| Mississippi | MEDICAID | 0880214 | |
| Mississippi | Other | 406165 | |
| Mississippi | MEDICAID | 004600368 |
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