Frederick, Douglas E

Frederick, Douglas E is an individual health care provider with primary practice located at 1947 N Founders Cir , Wichita KS 67206-3548. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Frederick, Douglas E can be contacted via phone (316) 613-4640.

Contact Information

Primary practice address
1947 N Founders Cir Wichita KS 67206-3548
Phone: (316) 613-4640
Fax: (316) 689-9769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 45623 Kansas

Profile Details

NPI number 1174528053
LBN Legal business name Frederick, Douglas E
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated May 19th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174528053 NPPES
Other 20041080A OK MEDICAID
MEDICAID 200278930E OK MEDICAID
Other 003719299 OK MEDICAID

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