Individual
DR. ERIC DALE RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O. D.
Contact information
Practice address
2708 WEST OXFORD LOOP, SUITE 110, OXFORD, MS 38655
(662) 380-5041
(662) 380-5042
Mailing address
2708 WEST OXFORD LOOP, SUITE 110, OXFORD, MS 38655
(662) 380-5041
(662) 380-5042
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
687
MS
152W00000X
Optometrist
687P-Y
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004600368
—
MS
05
—
0880214
—
MS
01
—
406165
MEDICARE
MS
Enumeration date
09/20/2006
Last updated
02/10/2023
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