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Organization

HARRY J. LANDRUM, JR, OD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HARRY J. LANDRUM JR. O.D. (PRESIDENT)
(856) 223-9100
Entity
Organization

Contact information

Practice address
10 BAKER BLVD, MULLICA HILL, NJ 08062-1504
(856) 223-9100
(856) 223-1626
Mailing address
10 BAKER BLVD, MULLICA HILL, NJ 08062-1504
(856) 223-9100
(856) 223-1626

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ML0431572
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000401703
HIGHMARK BLUE SHIELD ID
PA
01
0097517000
KEYSTONE HMO
PA
01
2014109
AETNA
NJ
05
6091601
NJ
01
802547
AMERIHEALTH
NJ
Enumeration date
03/22/2007
Last updated
12/08/2011
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