Individual
DR. FREDERICK THANE DEWEESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 CLINT HILL BLVD, PADUCAH, KY 42001-6768
(270) 442-9461
Mailing address
200 CLINT HILL BLVD, PADUCAH, KY 42001-6768
(270) 442-9461
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36333
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64028889
—
KY
Enumeration date
10/13/2005
Last updated
05/01/2024
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