Individual
JEFFREY RANDALL FRERKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1195 N OAKLAND AVE, BOLIVAR, MO 65613-8095
(417) 777-2121
(918) 619-4334
Mailing address
1195 N OAKLAND AVE, BOLIVAR, MO 65613-8095
(417) 777-2121
(918) 619-4334
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2025023940
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/28/2022
Last updated
01/19/2026
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