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Individual

ROBERT RAY FREDERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3366 NW EXPRESSWAY STE 730, OKLAHOMA CITY, OK 73112-4454
(405) 945-4905
(405) 945-4906
Mailing address
3366 NW EXPRESSWAY STE 730, OKLAHOMA CITY, OK 73112-4454
(405) 945-4905
(405) 945-4906

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA457
OK

Other

Enumeration date
11/11/2009
Last updated
11/11/2009
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