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Individual
DR. RICKEY P FIELDS
Active
Individual
DR. RICKEY P FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4207
KY
1223G0001X
General Practice Dentistry
4207
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45608916
EPSDT (A MEDICAID PROGRAM)
KY
05
—
60042074
—
KY
Enumeration date
02/12/2007
Last updated
06/15/2010
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