Individual
CRAIG JUDE FREDERICK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N LEWIS ST, NEW IBERIA, LA 70563-2043
(800) 893-9698
Mailing address
509 TERRELL CT, NEW IBERIA, LA 70563-2253
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23725
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1664286
—
LA
Enumeration date
05/01/2006
Last updated
07/08/2007
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