Provider Demographics
NPI:1710583257
Name:FIELDS, ANTHONY (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
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 1:648 N PLANKINTON AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53203-2928
Mailing Address - Country:US
Mailing Address - Phone:414-223-6874
Mailing Address - Fax:833-368-1247
Practice Address - Street 1:648 N PLANKINTON AVE STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203-2928
Practice Address - Country:US
Practice Address - Phone:414-223-6874
Practice Address - Fax:414-223-6821
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14021-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist