Provider Demographics
NPI:1891785580
Name:FIELDING, MARK L (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:L
Last Name:FIELDING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 MARTIN ST S
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35128-2360
Mailing Address - Country:US
Mailing Address - Phone:205-338-4545
Mailing Address - Fax:205-338-4553
Practice Address - Street 1:1021 MARTIN ST S
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128-2360
Practice Address - Country:US
Practice Address - Phone:205-338-4545
Practice Address - Fax:205-338-4553
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL331133195OtherCIGNA
AL51535377OtherBCBS OF ALABAMA
AL331133195OtherUHC
AL331133195OtherMAIL HANDLERS BENEFIT PLA
AL331133195OtherAETNA
AL51534991OtherBCBS OF ALABAMA
ALP00371913OtherRAILROAD MEDICARE
AL331133195OtherCIGNA
AL51534991OtherBCBS OF ALABAMA