Individual
DR. JON RANDALL FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8639 MAYLAND DR STE 102, RICHMOND, VA 23294-4752
(804) 993-3039
(804) 447-1953
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101242098
VA
207Q00000X
Family Medicine Physician
0101242098
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12723963
CAQH
VA
Enumeration date
10/18/2006
Last updated
10/25/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us