Randy L Light is a Ocularist in Peoria, Illinois. Randy L Light practices all healthcare services and medical treatments related to Ocularist. The NPI Number for Randy L Light is 1124060074. The last update date is 2009-07-03.
Randy L Light's current location address is 1318 W Candletree Dr, Peoria, Illinois. You can contact this provider via phone number 3096763663 and fax number 3096760359. The mailing address for Randy L Light is 1318 W Candletree Dr, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randy L Light |
|---|---|
| Address | 1318 W Candletree Dr, Peoria, Illinois |
| Phone Number | 3096763663 |
| Fax Number | 3096760359 |
| Sole Proprietor | N |
| Credentials | B.C.O., B. |
NPI Number Detail
| NPI Number | 1124060074 |
|---|---|
| Provider Enumeration Date | 2006-06-12 |
| Last Updated Date | 2009-07-03 |
Provider Mailing Address Detail
| Address | 1318 W Candletree Dr |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616148508 |
| Phone Number | 3096763663 |
| Fax Number | 3096760359 |
Provider's Primary Taxonomy Detail
| Speciality | Ocularist |
|---|---|
| Taxonomy | 156Fx1700X |
| Licence No | 203.000116 |
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Definition: An ocularist is a thoroughly trained professional skilled in the art of fitting, painting, and fabricating custom ocular prostheses. In addition to creating custom ocular prostheses, and providing long-term care through periodic examinations, an ocul |
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What is the unique 10-digit identification code assigned to Randy L Light by the Centers for Medicare & Medicaid Services?
The Randy L Light has been issued the NPI (National Provider Identifier) 1124060074, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Randy L Light's facilities are situated?
The facilities of Randy L Light are physically located at the following address: 1318 W Candletree Dr, Peoria, IL, 616148508.
What is the area of specialization for Randy L Light, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Randy L Light is Ocularist, and the corresponding taxonomy code that categorizes this area of expertise is 156Fx1700X.
On what date did Randy L Light receive its 1124060074 assignment from the Centers for Medicare & Medicaid Services?
The Randy L Light was assigned its 1124060074 on 2006-06-12, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Randy L Light's information last updated?
The Randy L Light's information was last updated on 2009-07-03.