Healthcare Provider Details

I. General information

NPI: 1184561524
Provider Name (Legal Business Name): JAMES FIELDS NRP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 S PINE ST
BONNE TERRE MO
63628-1635
US

IV. Provider business mailing address

PO BOX 579
BONNE TERRE MO
63628-0579
US

V. Phone/Fax

Practice location:
  • Phone: 573-366-3436
  • Fax:
Mailing address:
  • Phone: 573-366-3436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberP14007
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: