Individual
DR. CLAYTON JOSE FRIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3515 RICHMOND CIRCLE, GRAND ISLAND, NE 68803-4965
(308) 381-8636
(308) 381-8622
Mailing address
7440 SOUTH 91ST STREET, LINCOLN, NE 68526-9797
(402) 489-6555
(402) 328-3770
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
22964
NE
207RC0000X
Cardiovascular Disease Physician
Primary
22964
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0401410
—
IA
05
—
10026072300
—
NE
05
—
10026072400
—
NE
05
—
10026072500
—
NE
05
—
200536770A
—
KS
05
—
2401410
—
IA
05
—
47070592300
—
NE
05
—
47070592301
—
NE
05
—
47070592302
—
NE
05
—
47070592305
—
NE
05
—
47070592306
—
NE
05
—
47070592313
—
NE
Enumeration date
10/19/2006
Last updated
10/18/2012
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