Individual
DR. RANDY FRANKLIN CORNWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2312 23RD STREET, SPIRIT LAKE, IA 51360-1044
(712) 336-1960
Mailing address
PO BOX AG, SPIRIT LAKE, IA 51360-0328
(712) 336-1960
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02082
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1162032
—
IA
01
—
40832
WELLMARK BCBS OF IOWA
IA
Enumeration date
07/10/2006
Last updated
12/04/2007
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