Provider Demographics
NPI:1801905799
Name:FIELDS, RANDY STEVEN (OD)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:STEVEN
Last Name:FIELDS
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 1:923 STAGE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-5109
Mailing Address - Country:US
Mailing Address - Phone:334-821-3700
Mailing Address - Fax:334-821-3776
Practice Address - Street 1:923 STAGE RD
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-5109
Practice Address - Country:US
Practice Address - Phone:334-821-3700
Practice Address - Fax:334-821-3776
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS556 TA036152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000058001Medicaid
ALT69195Medicare UPIN
AL000058001Medicaid