Individual
RANDY STEPHEN COSHATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
112 5TH ST NE, ALICEVILLE, AL 35442-2200
(205) 373-6374
(205) 373-6163
Mailing address
112 5TH ST NE, ALICEVILLE, AL 35442-2200
(205) 373-6374
(205) 373-6163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-375-TA-023
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000059452
—
AL
01
—
0275270001
CIGNA GOVERNMENT SERVICES
—
01
—
51059452
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/09/2005
Last updated
11/24/2009
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