Individual
DR. CLIFTON J. RANDLE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1205 OLD HWY 127S, JAMESTOWN, TN 38556-3030
(931) 879-5897
(931) 879-8166
Mailing address
213 ROBERTS ST, LIVINGSTON, TN 38570-1505
(931) 823-3380
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD729
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3149057
BCBS
TN
05
—
3595162
—
TN
05
—
3595164
—
TN
05
—
3595167
—
TN
Enumeration date
05/31/2005
Last updated
01/23/2009
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