MEDICARE: ORLIN JAMES FICK O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	01817	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07372	OTHER	IA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1659350148	OTHER		BLOCK VISION
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	22-001144	OTHER		UHC
6	24361	OTHER		MIDLANDS CHOICE
7	930597	OTHER		EYEMED

General Provider Information

NPI Number	:	1659350148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ORLIN JAMES FICK O.D.

Provider Business Mailing Address
First Line	:	54 KEITH DR
Second Line	:
City	:	SHENANDOAH
State	:	IA
Zip	:	51601-2601
Country	:	US
Telephone Number	:	712-246-4526
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 W SHERIDAN AVE
Second Line	:
City	:	SHENANDOAH
State	:	IA
Zip	:	51601-1705
Country	:	US
Telephone Number	:	712-246-1786
Fax Number	:	712-246-1182

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	08/03/2012

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