Alldredge, Brooks Randall

Alldredge, Brooks Randall is an individual health care provider with primary practice located at 8220 San Pedro Dr Ne Suite 220, Albuquerque NM 87113-2476. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Alldredge, Brooks Randall can be contacted via phone (505) 797-4466.

Contact Information

Primary practice address
8220 San Pedro Dr Ne Suite 220 Albuquerque NM 87113-2476
Fax: (505) 797-2275
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X ODP-100001 Idaho
Eye and Vision Services Providers / Optometrist 152W00000X ATI2539 Oregon
Eye and Vision Services Providers / Optometrist 152W00000X OD00001864 Washington
Eye and Vision Services Providers / Optometrist 152W00000X OPT-OPT-LIC-2803 Montana
Eye and Vision Services Providers / Optometrist 152W00000X OPT589 New Mexico

Profile Details

NPI number 1154463099
LBN Legal business name Alldredge, Brooks Randall
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated Nov 12th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1154463099 NPPES
Idaho MEDICAID 8082271700
Idaho MEDICAID 01879341

Popular Providers