Provider Demographics
NPI:1548376932
Name:FRIDAY, STEVEN D (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:D
Last Name:FRIDAY
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 1:221 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47807-4214
Mailing Address - Country:US
Mailing Address - Phone:812-242-3700
Mailing Address - Fax:812-234-3565
Practice Address - Street 1:422 POPLAR ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-4209
Practice Address - Country:US
Practice Address - Phone:812-242-3700
Practice Address - Fax:812-234-3565
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002039A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
410020538OtherRAILROAD MCARE PALAMETTO
000000089633OtherANTHEM
IN100139370Medicaid
INP00818713OtherRAILROAD MEDICARE
000000089633OtherANTHEM
410020538OtherRAILROAD MCARE PALAMETTO
IN100139370Medicaid
T35111Medicare UPIN