Individual ProviderLarry S. FieldsFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1101 Saint Christopher Dr, Suite 250, Ashland, KY 41101-7087(606) 836-3196PECOS EnrollmentBased on the most recent information from CMS, provider Larry S. Fields does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1083612774Provider TypeIndividualFull NameFields, Larry S.CredentialMDGenderMaleSole ProprietorNoEnumeration Date7/7/2005Last Updated10/17/2012Contact InformationPractice LocationPractice Address1101 Saint Christopher Dr, Suite 250, Ashland, KY 41101-7087Phone(606) 836-3196Fax(606) 836-2564Mailing LocationMailing Address1101 Saint Christopher Dr, Suite 250, Ashland, KY 41101-7087Phone(606) 836-3196Fax(606) 836-2564Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense19519KentuckyProvider IdentifiersIDDescriptionIssuerID64195191DescriptionMedicaidIssuerUnlistedKentuckyID000000191982DescriptionOtherIssuerBLUE CROSS BLUE SHIELDID080172358DescriptionOtherIssuerRAILROAD MEDICAREID0536236DescriptionOtherIssuerOHIO MEDICAIDOhioIDF10727432DescriptionOtherIssuerOHIO MEDICAREOhio