Organization
FREDERICK MEDICAL CLINIC PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES DENZIL FREDERICK MD (ADMINISTRATION MEDICAL DIRECTOR)
(606) 743-3114
Entity
Organization
Contact information
Practice address
430 LIBERTY RD, WEST LIBERTY, KY 41472-2049
(606) 743-3114
(606) 743-1404
Mailing address
PO BOX 607, WEST LIBERTY, KY 41472-0607
(606) 743-3114
(606) 743-1404
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
183940
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35002013
—
KY
05
—
7100150550
—
KY
Enumeration date
09/12/2006
Last updated
12/12/2024
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