Individual
LORNA J FREDRIKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10565 N TATUM BLVD, SUITE # B-116, PARADISE VALLEY, AZ 85253-1095
(480) 991-3203
(480) 991-3997
Mailing address
10565 N TATUM BLVD, SUITE # B-116, PARADISE VALLEY, AZ 85253-1095
(480) 991-3203
(480) 991-3997
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
24587
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
364597
—
AZ
Enumeration date
06/18/2006
Last updated
12/05/2007
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