Individual
RYAN T. FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3 AUDUBON PLAZA DR STE LL2, LOUISVILLE, KY 40217-1360
(502) 636-8095
(502) 636-8097
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
46022
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000829991
ANTHEM - NIS
KY
01
—
149328
SIHO - NIS
KY
05
—
201203030
—
IN
01
—
50052491
PASSPORT-NIS
KY
05
—
7100193920
—
KY
Enumeration date
04/05/2010
Last updated
11/01/2019
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