Frerks, Tara Lee

Frerks, Tara Lee is an individual health care provider with primary practice located at 3916 N Intertech Ct , Appleton WI 54913. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Frerks, Tara Lee can be contacted via phone (920) 996-1000.

Contact Information

Primary practice address
3916 N Intertech Ct Appleton WI 54913
Phone: (920) 996-1000
Fax: (920) 996-1054
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 32903 South Carolina
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 32903 South Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 52283 Wisconsin

Profile Details

NPI number 1932353315
LBN Legal business name Frerks, Tara Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 11th, 2008
Last updated Mar 13th, 2019 - about 5 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 1932353315 NPPES
South Carolina Other 32903 SC MEDICAL LICENSE, MEDICAL BOARD
South Carolina Other 52283-020 SC MEDICAL LICENSE, MEDICAL BOARD

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