Provider Demographics
NPI:1437328242
Name:DR. JEFFREY L FIELDING
Entity Type:Organization
Organization Name:DR. JEFFREY L FIELDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MUNSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-225-5565
Mailing Address - Street 1:2013 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-2910
Mailing Address - Country:US
Mailing Address - Phone:918-225-5565
Mailing Address - Fax:918-225-5656
Practice Address - Street 1:2013 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-2910
Practice Address - Country:US
Practice Address - Phone:918-225-5565
Practice Address - Fax:918-225-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK977332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKT40442Medicare UPIN
OK0626760001Medicare NSC