# J BRIAN FREDERICK, M.D., PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437356532
- **Authorized official:** JAMES BRIAN FREDERICK (PRESIDENT)
- **Authorized official phone:** (606) 325-6888

## Contact information

- **Practice address:** 617 23RD ST STE 415, ASHLAND, KY 41101-2845
- **Practice address phone:** (606) 325-6888
- **Practice address fax:** (606) 326-9368
- **Mailing address:** 617 23RD ST STE 415, ASHLAND, KY 41101
- **Mailing address phone:** (606) 325-6888
- **Mailing address fax:** (606) 326-9368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 39332 | KY | Yes |

## Other

- **Enumeration date:** 07/02/2007
- **Last updated:** 03/12/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 64103179 | — | KY |