Individual
MR. RANDY W. GODWIN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DISPENSING OPTICIAN
Contact information
Practice address
1233 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4229
(919) 934-1272
(919) 934-1273
Mailing address
1233 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4229
(919) 934-1272
(919) 934-1273
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1508
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-5024935
—
NC
Enumeration date
11/23/2015
Last updated
11/23/2015
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