Provider Demographics
NPI:1578143228
Name:FIELDS, JOSHUA THOMAS
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:THOMAS
Last Name:FIELDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14755 W CAPITOL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2318
Mailing Address - Country:US
Mailing Address - Phone:262-781-3065
Mailing Address - Fax:
Practice Address - Street 1:14755 W CAPITOL DR STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2318
Practice Address - Country:US
Practice Address - Phone:262-781-3065
Practice Address - Fax:262-781-3835
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2025-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI82818208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics