Provider Demographics
NPI:1861595118
Name:FIELD, EDWARD D (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:D
Last Name:FIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5374
Mailing Address - Country:US
Mailing Address - Phone:662-234-0424
Mailing Address - Fax:662-234-0485
Practice Address - Street 1:2401 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5374
Practice Address - Country:US
Practice Address - Phone:662-234-0424
Practice Address - Fax:662-234-0485
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13319207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS200030049OtherRAILROAD MEDICARE NUMBER
MS00118675Medicaid
MS200030049OtherRAILROAD MEDICARE NUMBER
MSE95072Medicare UPIN
MS00118675Medicaid