Provider Demographics
NPI:1225105703
Name:DR BARBARA J FLUDER INC
Entity Type:Organization
Organization Name:DR BARBARA J FLUDER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLUDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:219-947-8100
Mailing Address - Street 1:5061 E LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5912
Mailing Address - Country:US
Mailing Address - Phone:219-947-8100
Mailing Address - Fax:219-947-8119
Practice Address - Street 1:5061 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5912
Practice Address - Country:US
Practice Address - Phone:219-947-8100
Practice Address - Fax:219-947-8119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5791900001Medicare NSC