Randolph, Antwan Percy

Randolph, Antwan Percy is an sole proprietor health care provider with primary practice located at 2549 Yukon Pl , Spearfish SD 57783-8531. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Randolph, Antwan Percy can be contacted via phone (605) 549-1212.

Contact Information

Primary practice address
2549 Yukon Pl Spearfish SD 57783-8531
Phone: (605) 549-1212
Fax: (605) 549-1313
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2010002259 Missouri
Eye and Vision Services Providers / Optometrist 152W00000X 2911 Tennessee
Eye and Vision Services Providers / Vision Therapy 152WV0400X 748 South Dakota
Eye and Vision Services Providers / Optometrist 152W00000X 748 South Dakota

Profile Details

NPI number 1568798841
LBN Legal business name Randolph, Antwan Percy
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2009
Last updated Sep 15th, 2021 - about 5 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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