Individual
MR. RANDYN SHAMAR MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO, LDO
Contact information
Practice address
4100 S FERDON BLVD, CRESTVIEW, FL 32536-5252
(850) 204-4762
Mailing address
4100 S FERDON BLVD STE C2, CRESTVIEW, FL 32536-5287
(850) 204-4762
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
DPO3507
TN
156FX1800X
Optician
LDO002944
GA
156FX1800X
Optician
LDO7360
FL
156FX1900X
Orthoptist
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
03/10/2026
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