Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2793 | OK |
NPI | 1013359504 |
---|---|
Provider Name | Dr. Randall Scott Sauer |
First Address | Stillwater, OK 74074-4200 |
Second Address | Stillwater, OK 74074-4200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2013 |
Last Update Date | 30/06/2014 |