Individual
MR. FREDRIC A WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
761 BUFFINGTON RD, WESTVILLE, OK 74965-7011
(918) 723-3997
(918) 723-3889
Mailing address
PO BOX 408, WESTVILLE, OK 74965-0408
(918) 723-5456
(918) 723-4080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1075
OK
363A00000X
Physician Assistant
PA238
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100074610A
—
OK
05
—
100074610D
—
OK
Enumeration date
05/12/2006
Last updated
06/04/2019
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