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Individual

WILLIAM FIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
321 S PARK AVE, HERRIN, IL 62948-3603
(618) 942-2900
(618) 942-4199
Mailing address
1200 W DEYOUNG ST, MARION, IL 62959-4437
(618) 993-5686
(618) 997-6250

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007446
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046007446
IL
01
051353
HEALTH ALLIANCE
01
0814870001
MEDICARE NSC NUMBER
IL
01
0814870007
MEDICARE NSC NUMBER
IL
01
0814870019
MEDICARE NSC NUMBER
IL
01
237369
HARMONY HEALTH PLAN
01
410039812
MEDICARE RAILROAD
IL
01
IL7446
EYEMED
Enumeration date
09/30/2005
Last updated
10/01/2008
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