Provider Demographics
NPI:1588809586
Name:FIELDS, KENNETH JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:JAMES
Last Name:FIELDS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4353 E STATE ROUTE 73
Mailing Address - Street 2:SUITE 140
Mailing Address - City:WAYNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45068-8812
Mailing Address - Country:US
Mailing Address - Phone:513-897-0182
Mailing Address - Fax:513-897-6221
Practice Address - Street 1:4353 E STATE ROUTE 73
Practice Address - Street 2:SUITE 140
Practice Address - City:WAYNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45068-8812
Practice Address - Country:US
Practice Address - Phone:513-897-0182
Practice Address - Fax:513-897-6221
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-05
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032278621835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist