Randolph, Katherine Cragon
Randolph, Katherine Cragon is an individual health care provider with primary practice located at 130 W Van Dorn Ave , Holly Springs MS 38635. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Randolph, Katherine Cragon can be contacted via phone (662) 252-3323.Contact Information
Primary practice address
130 W Van Dorn Ave
Holly Springs MS 38635
Phone: (662) 252-3323
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 957 | Mississippi |
Profile Details
| NPI number | 1336557222 |
|---|---|
| LBN Legal business name | Randolph, Katherine Cragon |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 24th, 2014 |
| Last updated | Aug 27th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336557222 | NPPES |
| Mississippi | MEDICAID | 05500018 |
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