Provider Demographics
NPI:1770575904
Name:FIELD, LARRY WILLIAM (DO, MBA)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:WILLIAM
Last Name:FIELD
Suffix:
Gender:M
Credentials:DO, MBA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3101 SW 34TH AVE
Mailing Address - Street 2:#905-454
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7447
Mailing Address - Country:US
Mailing Address - Phone:352-895-9546
Mailing Address - Fax:815-352-1571
Practice Address - Street 1:3101 SW 34TH AVE
Practice Address - Street 2:#905-454
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7447
Practice Address - Country:US
Practice Address - Phone:352-895-9546
Practice Address - Fax:815-352-1571
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005612207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80467OtherBCBS
FL80467OtherBCBS
FLE84322Medicare UPIN