Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2665 | AZ |
Y | 207QS0010X | Family Doctor - Sports Medicine | 2665 | AZ |
NPI | 1235134552 |
---|---|
Provider Name | Dr. Thomas C Fiel |
First Address | Tempe, AZ 85283-1510 |
Second Address | Tempe, AZ 85283-1510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 26/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F27087 | (02) | AZ |