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Individual

FREDERICK R WITTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
(812) 282-4172
Mailing address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
(812) 282-4172

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
01040421A
IN
208800000X
Urology Physician
Primary
23489
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201011460
IN
05
64234891
KY
01
P00304320
RAILROAD MEDICARE
KY
01
P00895255
RAILROAD MEDICARE
KY
Enumeration date
08/24/2005
Last updated
09/25/2017
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