Provider Demographics
NPI:1275610750
Name:FIELDS, JEFFREY J (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:FIELDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11414 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-3973
Mailing Address - Country:US
Mailing Address - Phone:865-966-3621
Mailing Address - Fax:865-966-4335
Practice Address - Street 1:11414 KINGSTON PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3973
Practice Address - Country:US
Practice Address - Phone:865-966-3621
Practice Address - Fax:865-966-4335
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000000255111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0084180OtherBLUE CROSS BLUE SHEILD
TN9264793OtherPHCS
TN7398518OtherCIGNA
TN7398518OtherCIGNA
TN9264793OtherPHCS