Frederick, Keith J.

Frederick, Keith J. is an individual health care provider with primary practice located at 1050 W 10Th St , Rolla MO 65401-2905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Frederick, Keith J. can be contacted via phone (573) 364-5633.

Contact Information

Primary practice address
1050 W 10Th St Rolla MO 65401-2905
Fax: (573) 426-5314
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X R4D88 Missouri

Profile Details

NPI number 1366552762
LBN Legal business name Frederick, Keith J.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Aug 22nd, 2019 - about 6 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 1366552762 NPPES
Missouri MEDICAID 242256303

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