Organization
FREDERIC A. HUMPHREY,D.O.INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERIC ADAIR HUMPHREY D.O. (PRESIDENT)
17403744590
Entity
Organization
Contact information
Practice address
4727 STATE ROUTE 60, MARIETTA, OH 45750-5360
(740) 374-4590
(740) 568-0310
Mailing address
4727 STATE ROUTE 60, MARIETTA, OH 45750-5360
(740) 374-4590
(740) 568-0310
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34002561H
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083356000
—
WV
05
—
0367802
—
OH
Enumeration date
05/03/2007
Last updated
06/17/2008
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