Provider Demographics
NPI:1922061522
Name:FIELDS, AARON M (DO)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:M
Last Name:FIELDS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9000
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-9000
Mailing Address - Country:US
Mailing Address - Phone:719-553-2200
Mailing Address - Fax:719-553-2213
Practice Address - Street 1:3676 PARKER BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2212
Practice Address - Country:US
Practice Address - Phone:719-553-2201
Practice Address - Fax:719-553-2224
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0051862207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO25435868Medicaid
CO105589Medicare PIN
KSI54490Medicare UPIN
KS200383910CMedicaid
105589Medicare PIN
KS200383910AMedicaid
CO105589Medicare PIN
CO200383910AMedicaid
KS110173178Medicare PIN