Frederickson, Thomas W

Frederickson, Thomas W is an individual health care provider with primary practice located at 7500 Mercy Rd , Omaha NE 68124-2319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Frederickson, Thomas W can be contacted via phone (402) 343-4328.

Contact Information

Primary practice address
7500 Mercy Rd Omaha NE 68124-2319
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 04-26524 Kansas
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 108755 Missouri
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 26061 Nebraska

Profile Details

NPI number 1295728368
LBN Legal business name Frederickson, Thomas W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated Sep 29th, 2016 - about 9 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 1295728368 NPPES
Kansas MEDICAID 100293960B
Kansas Other 110199606
Kansas Other P00652380
Kansas Other 738529
Kansas MEDICAID 100293960D
Kansas MEDICAID 208471714
Kansas Other 2292243
Kansas Other 23432040

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