Individual
RANDALL MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1218DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77012185
—
KY
Enumeration date
09/23/2006
Last updated
08/27/2024
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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