Basic Information
Provider Information
NPI: 1962060624
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIELD
FirstName: MATTHEW
MiddleName: GARRETT
NamePrefix:  
NameSuffix:  
Credential: MD, PHD, MSPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 HAWKINS DR DEPT OF
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193562852
FaxNumber: 3193561520
Practice Location
Address1: 200 HAWKINS DR DEPT OF
Address2:  
City: IOWA CITY
State: IA
PostalCode: 522421009
CountryCode: US
TelephoneNumber: 3193562852
FaxNumber: 3193561520
Other Information
ProviderEnumerationDate: 05/29/2019
LastUpdateDate: 11/16/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XR-11586IAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207W00000XR-11586IAY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


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