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General NPI Number Information
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NPI Number | 1538162896
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Entity Type | Individual
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Provider Name | LARRY MICHAEL FIELDS MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 501 19TH ST SUITE 406
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City | KNOXVILLE
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State | TN
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Zip | 37916-1854
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Country | US
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Telephone | 865-541-2695
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Fax | 865-541-2696
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Provider Business Mailing Address
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Address Line | 501 19TH ST SUITE 304
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City | KNOXVILLE
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State | TN
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Zip | 37916-1854
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Country | US
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Telephone | 865-541-2695
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Fax | 865-541-2696
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD35436
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License Number State | TN
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