Individual
CHAD FREDERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
INFIRMARY RD, BATON ROUGE, LA 70803-2401
(225) 578-5633
(225) 578-5655
Mailing address
INFIRMARY RD, BATON ROUGE, LA 70803-2401
(225) 578-5633
(225) 578-5655
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
ATH.200132
LA
2255A2300X
Athletic Trainer
ATH.200132
LA
Other
Enumeration date
05/13/2013
Last updated
05/01/2025
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