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General NPI Number Information
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NPI Number | 1164962700
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Entity Type | Individual
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Provider Name | CHRISTOPHER DALE FIELDS
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Gender | Male
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 725 PARKWAY STE 11
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City | SEVIERVILLE
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State | TN
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Zip | 37862-4354
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Country | US
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Telephone | 865-428-7252
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Fax |
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Provider Business Mailing Address
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Address Line | 7834 MENDONHALL ESTATES BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37938-4424
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0000035688
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License Number State | TN
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