Individual
DR. BLAKE FREDERICKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
900 S LIMESTONE, CTW 304, LEXINGTON, KY 40536-0293
(859) 323-2834
Mailing address
900 S LIMESTONE, CTW 304, LEXINGTON, KY 40536-0293
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
KY
Other
Enumeration date
03/31/2026
Last updated
04/03/2026
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