Fredericks, Leroy E

Fredericks, Leroy E is an individual health care provider with primary practice located at 2770 3Rd Ave Ste 210 , Lake Charles LA 70601-0404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Fredericks, Leroy E can be contacted via phone (337) 494-6768.

Contact Information

Primary practice address
2770 3Rd Ave Ste 210 Lake Charles LA 70601-0404
Phone: (337) 494-6768
Fax: (337) 494-6792
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X MD10005R Louisiana

Profile Details

NPI number 1043335755
LBN Legal business name Fredericks, Leroy E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Apr 27th, 2022 - about 4 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 1043335755 NPPES
Louisiana MEDICAID 1491217
Louisiana Other MD.10005R

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