Provider Demographics
NPI:1861495061
Name:FAIRFIELD, JAMES CLARKE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CLARKE
Last Name:FAIRFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2827 E FIELDSTONE WAY
Mailing Address - Street 2:UNIT 2227
Mailing Address - City:STURTEVANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-1997
Mailing Address - Country:US
Mailing Address - Phone:262-456-9720
Mailing Address - Fax:866-388-2572
Practice Address - Street 1:2827 E FIELDSTONE WAY
Practice Address - Street 2:UNIT 2227
Practice Address - City:STURTEVANT
Practice Address - State:WI
Practice Address - Zip Code:53177-1997
Practice Address - Country:US
Practice Address - Phone:262-456-9720
Practice Address - Fax:866-388-2572
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018193E207N00000X
WI60705 - 20207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology