Provider Demographics
NPI:1083990881
Name:FIELDS, DAVID CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:FIELDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 570
Mailing Address - Street 2:1001 HIGHWAY 414 NORTH
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:WY
Mailing Address - Zip Code:82939-0570
Mailing Address - Country:US
Mailing Address - Phone:307-782-6601
Mailing Address - Fax:
Practice Address - Street 1:125 E. CANAL ST.
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:WY
Practice Address - Zip Code:82937-0432
Practice Address - Country:US
Practice Address - Phone:307-747-2366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator