Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 18928 | OK |
NPI | 1275508186 |
---|---|
Provider Name | Bret N Frey |
First Address | Oklahoma City, OK 73112-5555 |
Second Address | Enid, OK 73703-1729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 17/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100714960B | (05) | OK |
G70492 | (02) |