Individual
LEWIS BRADLEY FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 S CHURCH ST, SUITE 302, JONESBORO, AR 72401-4176
(870) 935-3990
(870) 935-0871
Mailing address
800 S CHURCH ST, SUITE 302, JONESBORO, AR 72401-4176
(870) 935-3990
(870) 935-0871
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
N6969
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111703001
—
AR
01
—
12878000040
QUALCHOICE
AR
01
—
160028625
MEDICARE RAILROAD COARRIE
AR
01
—
54057
BLUE CROSS
AR
01
—
770138201
EDS BREASTCARE
AR
01
—
9813669
CIGNA
—
01
—
AS0140035
HUMANA TRICARE
—
Enumeration date
01/26/2006
Last updated
09/12/2012
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