Provider Demographics
NPI:1265405716
Name:FIELD, KATIE M (OD)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:M
Last Name:FIELD
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 1:151 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247
Mailing Address - Country:US
Mailing Address - Phone:413-662-2020
Mailing Address - Fax:413-662-2908
Practice Address - Street 1:151 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247
Practice Address - Country:US
Practice Address - Phone:413-662-2020
Practice Address - Fax:413-662-2908
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0326241Medicaid
U98619Medicare UPIN
MA0326241Medicaid