Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 35381 | MN |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 56127-20 | WI |
NPI | 1336105840 |
---|---|
Provider Name | Thomas G Field |
First Address | Baldwin, WI 54002-2600 |
Second Address | Baldwin, WI 54002-2600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 15/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87989 | (02) | MN |