Provider Demographics
NPI:1366689069
Name:SURGICAL SPECIALISTS FIELD & NEWBOLD PLLC
Entity Type:Organization
Organization Name:SURGICAL SPECIALISTS FIELD & NEWBOLD PLLC
Other - Org Name:SURGICAL SPECIALISTS OF WALLA WALLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:I
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-525-1800
Mailing Address - Street 1:1017 S 2ND AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4183
Mailing Address - Country:US
Mailing Address - Phone:509-525-1800
Mailing Address - Fax:509-525-7515
Practice Address - Street 1:1017 S 2ND AVE
Practice Address - Street 2:STE 3
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4183
Practice Address - Country:US
Practice Address - Phone:509-525-1800
Practice Address - Fax:509-525-7515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty