Provider Demographics
NPI:1265045884
Name:FIELD MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:FIELD MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELL JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-957-8337
Mailing Address - Street 1:3017 W CHARLESTON BLVD STE 70
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1928
Mailing Address - Country:US
Mailing Address - Phone:702-957-8337
Mailing Address - Fax:
Practice Address - Street 1:3017 W CHARLESTON BLVD STE 70
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1928
Practice Address - Country:US
Practice Address - Phone:702-957-8337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty