Provider Demographics
NPI:1578769865
Name:SKOLFIELD, JULIE (OD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:SKOLFIELD
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 1:321 RICHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6612
Mailing Address - Country:US
Mailing Address - Phone:337-988-6239
Mailing Address - Fax:
Practice Address - Street 1:2813 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3243
Practice Address - Country:US
Practice Address - Phone:337-232-1404
Practice Address - Fax:337-234-2905
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16-15844-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1664995Medicaid