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General NPI Number Information
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NPI Number | 1285718387
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Entity Type | Individual
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Provider Name | HARRY J. LANDRUM JR. O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10 BAKER BLVD
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City | MULLICA HILL
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State | NJ
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Zip | 08062-1504
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Country | US
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Telephone | 856-223-9100
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Fax | 856-223-1626
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Provider Business Mailing Address
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Address Line | 10 BAKER BLVD
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City | MULLICA HILL
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State | NJ
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Zip | 08062-1504
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Country | US
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Telephone | 856-223-9100
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Fax | 856-223-1626
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27TO00052500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00448000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG0011641
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OA4480
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TO00525
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License Number State | PA
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