Eason, Randy Dawayne
Eason, Randy Dawayne is an sole proprietor health care provider with primary practice located at 516 Airport Rd , Forest MS 39074-4032. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Eason, Randy Dawayne can be contacted via phone (601) 469-2020.Contact Information
Primary practice address
516 Airport Rd
Forest MS 39074-4032
Phone: (601) 469-2020
Fax: (601) 469-5686
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 481 | Mississippi |
Profile Details
| NPI number | 1417048620 |
|---|---|
| LBN Legal business name | Eason, Randy Dawayne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417048620 | NPPES |
| Mississippi | MEDICAID | 00088059 |
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