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General NPI Number Information
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NPI Number | 1376756809
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Entity Type | Organization
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Legal Business Name | BRADLEY W. FIELDING OPTOMETRIST, INC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 13 N UNIVERSITY DR
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City | EDMOND
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State | OK
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Zip | 73034-5206
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Country | US
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Telephone | 405-341-3567
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Fax | 405-359-2000
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Provider Business Mailing Address
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Address Line | 13 N UNIVERSITY DR
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City | EDMOND
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State | OK
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Zip | 73034-5206
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Country | US
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Telephone | 405-341-3567
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Fax | 405-359-2000
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. BRADLEY WILLIAM FIELDING
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Credential | O.D.
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Telephone | 405-341-3567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OK1080
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License Number State | OK
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