Healthcare Provider Details

I. General information

NPI: 1023178332
Provider Name (Legal Business Name): DANIEL D FIELDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WEST 7TH STREET SUITE 6
BRISTOW OK
74010
US

IV. Provider business mailing address

700 WEST 7TH STREET SUITE 6
BRISTOW OK
74010
US

V. Phone/Fax

Practice location:
  • Phone: 918-367-4443
  • Fax: 918-367-9190
Mailing address:
  • Phone: 918-367-4443
  • Fax: 913-367-9190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18055
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: