Organization
OSAGE BONE AND JOINT CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH J. FREDERICK DO (PHYSICIAN)
(573) 364-5633
Entity
Organization
Contact information
Practice address
1000 W 10TH ST, STE A, ROLLA, MO 65401-2905
(573) 364-5633
(573) 426-5314
Mailing address
1836 LACKLAND HILL PKWY, ATTNT: CREDENTIALING DEPARTMENT, SAINT LOUIS, MO 63146-3572
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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