Individual
CHARLES THOMAS FIELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29 NW 1ST LANE, LAMAR, MO 64759-8105
(417) 681-5100
(417) 681-5510
Mailing address
PO BOX 7411626, CHICAGO, IL 60674-5626
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R5G49
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096060A
—
OK
05
—
202389946
—
MO
Enumeration date
07/19/2006
Last updated
08/22/2025
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