Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RANDYN SHAMAR MCMILLAN, CO, LDO
ActiveOcular Prosthetist · MEMPHIS, TN
Registration Details
- NPI Number
- 1124775168
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 9, 2022 (4.1224080474468 yrs)
- Last Updated
- Mar 9, 2022
- Licenses
-
DPO3507 (TN)LDO7360 (FL)
Practice Information
- Address
-
930 MADISON AVE STE 400MEMPHIS, TN, 381037400Browse TN providers · Browse ZIP 38103
- Phone
- 9012877337
- Primary Specialty
-
Ocular Prosthetist
156FX1900X
- Additional Specialty
- Optician, Dispensing
- Additional Specialty
- Ocular Prosthetist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.