Edwards, Randall Lee

Edwards, Randall Lee is an individual health care provider with primary practice located at 501 Kansas City St , Rapid City SD 57701-3673. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Edwards, Randall Lee can be contacted via phone (605) 348-2323.

Contact Information

Primary practice address
501 Kansas City St Rapid City SD 57701-3673
Phone: (605) 348-2323
Fax: (605) 348-6694
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 466 South Dakota

Profile Details

NPI number 1467502518
LBN Legal business name Edwards, Randall Lee
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Jul 8th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467502518 NPPES
South Dakota MEDICAID 9202713

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