Provider Demographics
NPI:1730242116
Name:FIELDS, ELBERT PAYSON JR (DC)
Entity type:Individual
Prefix:DR
First Name:ELBERT
Middle Name:PAYSON
Last Name:FIELDS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:680 DOUTHIT FERRY RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-4150
Mailing Address - Country:US
Mailing Address - Phone:770-387-3161
Mailing Address - Fax:770-387-3162
Practice Address - Street 1:680 DOUTHIT FERRY RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-4150
Practice Address - Country:US
Practice Address - Phone:770-387-3161
Practice Address - Fax:770-387-3162
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFMGMedicare ID - Type Unspecified