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Individual

RICHARD FIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
319 BROAD ST, BAXTER, TN 38544-5117
(931) 858-2116
(931) 858-2117
Mailing address
319 BROAD ST, BAXTER, TN 38544-5117
(931) 858-2116
(931) 858-2117

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17368
TN
207QA0505X
Adult Medicine Physician
17368
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3023449
TN
01
3144641
BCBS OF TN
TN
01
50014552
PASSPORT
KY
05
64008857
KY
01
P00327914
RAILROAD MEDICARE
TN
Enumeration date
06/09/2006
Last updated
01/23/2020
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