Individual
LARRY S. FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 SAINT CHRISTOPHER DR, SUITE 250, ASHLAND, KY 41101-7087
(606) 836-3196
(606) 836-2564
Mailing address
1101 SAINT CHRISTOPHER DR, SUITE 250, ASHLAND, KY 41101-7087
(606) 836-3196
(606) 836-2564
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19519
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000191982
BLUE CROSS BLUE SHIELD
—
01
—
0536236
OHIO MEDICAID
OH
01
—
080172358
RAILROAD MEDICARE
—
05
—
64195191
—
KY
01
—
F10727432
OHIO MEDICARE
OH
Enumeration date
07/07/2005
Last updated
10/17/2012
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