Individual
DR. LORI ANN FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2601 KELLEY POINTE PKWY, STE. 101, EDMOND, OK 73013-2995
(405) 844-2601
(405) 844-2610
Mailing address
2601 KELLEY POINTE PKWY, STE. 101, EDMOND, OK 73013-2995
(405) 844-2601
(405) 844-2610
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
23964
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225243207
NPI
OK
01
—
800522205
PTAN
—
Enumeration date
05/11/2007
Last updated
11/17/2011
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