Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 38425 | OK |
NPI | 1013588276 |
---|---|
Provider Name | Evan Fields |
First Address | Yukon, OK 73099-3558 |
Second Address | Oklahoma City, OK 73104-5036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2021 |
Last Update Date | 14/07/2021 |