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Individual

DR. RICKEY P FIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
225 WINDSOR DR, MT STERLING, KY 40353
(859) 498-3400
Mailing address
225 WINDSOR DR, MT STERLING, KY 40353
(859) 498-3400

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4207
KY
1223G0001X
General Practice Dentistry
4207
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
45608916
EPSDT (A MEDICAID PROGRAM)
KY
05
60042074
KY
Enumeration date
02/12/2007
Last updated
06/15/2010
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