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NPI 1750315040ActiveOrganization· Optometrist· Spirit Lake, IA

Optometrist in Spirit Lake, Iowa, registered in NPPES in July 2006. The authorized official on file is Randy Franklin Cornwall, OD, Partner. Enrolled in Medicare as dme supplier - physician - optometrist and part b supplier - clinic/group practice.

Overview

NPI1750315040
StatusActive
Entity typeOrganization
NPI issuedJul 10, 2006
Last updated in NPPESAug 26, 2008

Specialties and licenses

TaxonomyCodeLicenseState
Optometrist Primary152W00000X02082IA
Optometrist152W00000X01903IA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled DME Supplier - Physician - Optometrist (IA); Part B Supplier - Clinic/Group Practice (IA)

Medicare sources and data years

Other Optometrist providers in Spirit Lake

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