Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 45193 | OH |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 45193 | OH |
NPI | 1083764351 |
---|---|
Provider Name | Charles Mitchell Fields |
First Address | Chillicothe, OH 45601-9197 |
Second Address | Chillicothe, OH 45601-8620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 14/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0560156 | (05) | OH |
C46431 | (02) | OH |