1356390991 NPI number — DR. JOHN M FEILD DPM

Table of content: DR. JOHN M FEILD DPM (NPI 1356390991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356390991 NPI number — DR. JOHN M FEILD DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEILD
Provider First Name:
JOHN
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356390991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2530 N 8TH ST STE 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND JUNCTION
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81501-8858
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-245-3338
Provider Business Mailing Address Fax Number:
970-245-9499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2530 N 8TH ST STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND JUNCTION
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81501-8858
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-245-3338
Provider Business Practice Location Address Fax Number:
970-245-9499
Provider Enumeration Date:
05/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  CO355 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01003557 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 480028326 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1356390991 . This is a "NPI" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1356390991 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 1720207863 . This is a "NPIGROUP" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".