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Individual

MR. RANDALL SHANE MYERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
21 S 9TH ST, DUNCAN, OK 73533-4909
(580) 470-9490
(580) 470-9502
Mailing address
21 S 9TH ST, DUNCAN, OK 73533-4909
(580) 470-9490
(580) 470-9502

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
13-D-1200
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201453400001
BCBS
Enumeration date
02/09/2007
Last updated
07/08/2007
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