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Individual

DEAN RANDOLPH BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
650 E PINE ST, STE 105, CENTRAL POINT, OR 97502-2482
(541) 664-5535
(541) 664-7745
Mailing address
650 E PINE ST, STE 105, CENTRAL POINT, OR 97502-2482
(541) 664-5535
(541) 664-7745

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2302ATI
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
029715
OR
01
807295000
REGENCE BLUE CROSS
OR
Enumeration date
06/24/2005
Last updated
09/10/2009
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