Provider Demographics
NPI:1790763167
Name:FLEMING, DARRIN PATRICK (OD)
Entity Type:Individual
Prefix:DR
First Name:DARRIN
Middle Name:PATRICK
Last Name:FLEMING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 WILLAMETTE ST # 17
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4049
Mailing Address - Country:US
Mailing Address - Phone:541-762-2763
Mailing Address - Fax:541-434-0912
Practice Address - Street 1:1550 OAK ST STE 4
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7701
Practice Address - Country:US
Practice Address - Phone:541-762-2763
Practice Address - Fax:541-434-0912
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4026AT152W00000X
ORATI-4026152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR079707Medicaid
OR041WFBWCAMedicare ID - Type Unspecified
ORU31014Medicare UPIN
OR1204460001Medicare NSC