Frederick, Jeffrey Alan

Frederick, Jeffrey Alan is an individual health care provider with primary practice located at 3650 W Rock Creek Rd 110A, Norman OK 73072-2202. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Frederick, Jeffrey Alan can be contacted via phone (405) 364-2666.

Contact Information

Primary practice address
3650 W Rock Creek Rd 110A Norman OK 73072-2202
Phone: (405) 364-2666
Fax: (405) 364-9627
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA 936 Oklahoma

Profile Details

NPI number 1093743957
LBN Legal business name Frederick, Jeffrey Alan
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2006
Last updated Jul 15th, 2013 - about 12 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 1093743957 NPPES
Oklahoma MEDICAID 100189640 A

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