Provider Demographics
NPI:1255826541
Name:FIELDS, LINDSEY M (OD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:M
Last Name:FIELDS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 BROADWAY EYE CENTER NORTHEAST DBA NORTHEAST EYECARE
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-990-4388
Mailing Address - Fax:207-947-9241
Practice Address - Street 1:955 BROADWAY EYE CENTER NORTHEAST DBA NORTHEAST EYECARE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-990-4388
Practice Address - Fax:207-947-9241
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT997152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist