Basic Information
| Provider Information | |||||||||
| NPI: | 1962498196 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIELDS | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | ERNEST | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7777 HENNESSY BLVD STE 701 | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708084370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257655864 | ||||||||
| FaxNumber: | 2252147003 | ||||||||
| Practice Location | |||||||||
| Address1: | 7777 HENNESSY BLVD STE 701 | ||||||||
| Address2: | |||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708084370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257655864 | ||||||||
| FaxNumber: | 2257652013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2005 | ||||||||
| LastUpdateDate: | 12/28/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 023084 | LA | N | Other Service Providers | Specialist | 207RP1001X | 023084 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | 023084 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1494259 | 05 | LA | MEDICAID | 5H768BD12 | 01 | MEDICARE | OTHER | 01034394 | 05 | MS | MEDICAID |