Provider Demographics
NPI:1326024647
Name:FIELDS, WILLIAM MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
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 1:2925 JOHN WILLIAMS BLVD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-6426
Mailing Address - Country:US
Mailing Address - Phone:812-278-3154
Mailing Address - Fax:812-278-3158
Practice Address - Street 1:2925 JOHN WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-6426
Practice Address - Country:US
Practice Address - Phone:812-278-3154
Practice Address - Fax:812-278-3158
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200229680BMedicaid
IN200229680BMedicaid
IN75787Medicare UPIN