Individual
MRS. CARRIE LINDA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1505 E MAIN ST, STIGLER HEALTH AND WELLNESS, STIGLER, OK 74462-2913
(918) 967-3368
(918) 967-3351
Mailing address
2525 CHANDLER RD, MUSKOGEE, OK 74403-5088
(918) 681-7533
(918) 684-9033
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1077570
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200122650A
—
OK
Enumeration date
09/13/2007
Last updated
06/26/2015
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