Individual
DR. GAIL EVERETT FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
53 POPLAR ST, BLACKFOOT, ID 83221-1737
(208) 785-2220
(208) 785-2228
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-2220
(208) 785-2228
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
O-84
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149436
REGENCE BLUE SHIELD
ID
05
—
000325400
—
ID
01
—
244230
ALTIUS OLD
ID
01
—
313149
ALTIUS
ID
01
—
S5528
BLUE CROSS OLD
ID
01
—
S6113
BLUE CROSS
ID
Enumeration date
06/23/2005
Last updated
05/30/2008
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