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Organization

CHARLES D FIELD III OD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBBIE KAY WICKLINE (OFFICE MANAGER)
(304) 253-3150
Entity
Organization

Contact information

Practice address
701 S OAKWOOD AVE, BECKLEY, WV 25801-5929
(304) 253-3150
(304) 252-9087
Mailing address
701 S OAKWOOD AVE, BECKLEY, WV 25801-5929
(304) 253-3150
(304) 252-9087

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
582-OD
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001522821
BLUE CROSS BLUE SHIELD
WV
05
0150202000
WV
Enumeration date
06/06/2008
Last updated
06/20/2008
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