Individual
DR. STEVE RANDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
307 SOUTH MAIN ST, AMORY, MS 38821
(662) 256-8481
(662) 256-5276
Mailing address
307 SOUTH MAIN ST, AMORY, MS 38821
(662) 256-8481
(662) 256-5276
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
640715180
MS
152W00000X
Optometrist
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087048
—
MS
01
—
410002688
RAILROAD MEDICARE
MS
01
—
477949
ADVANTRA FREEDOM
MS
Enumeration date
07/05/2006
Last updated
07/21/2022
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