Provider Demographics
NPI:1144007071
Name:RANDI L DAY OD LLC
Entity type:Organization
Organization Name:RANDI L DAY OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:580-445-1066
Mailing Address - Street 1:121 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-1805
Mailing Address - Country:US
Mailing Address - Phone:580-445-1066
Mailing Address - Fax:
Practice Address - Street 1:818 FRISCO AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3323
Practice Address - Country:US
Practice Address - Phone:580-440-0077
Practice Address - Fax:580-200-1096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200212850AMedicaid