Individual
MADISON J FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
355 QUARTERMASTER CT, JEFFERSONVILLE, IN 47130-3670
(812) 258-9802
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(317) 449-4833
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22007074A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891820668
NPI
IN
05
—
200533240G
—
IN
Enumeration date
11/07/2018
Last updated
11/07/2018
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