Provider Demographics
NPI:1225240351
Name:DR IAN FIELD OPTOMETRIST PA
Entity Type:Organization
Organization Name:DR IAN FIELD OPTOMETRIST PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-392-2030
Mailing Address - Street 1:5571 W HILLSBORO BLVD
Mailing Address - Street 2:WAL-MART VISION CENTER
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4376
Mailing Address - Country:US
Mailing Address - Phone:954-574-6735
Mailing Address - Fax:
Practice Address - Street 1:5571 W HILLSBORO BLVD
Practice Address - Street 2:WALMART VISION CENTER
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4376
Practice Address - Country:US
Practice Address - Phone:954-574-6735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1216152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T85201Medicare UPIN