Dr. Leroy E Fredericks
Hematology & Oncology
2770 3rd Ave Ste 350
Lake Charles
, Louisiana 70601-0404
Dr. Leroy E Fredericks
Hematology & Oncology
2770 3rd Ave Ste 350
Lake Charles
, Louisiana 70601-0404
(337) 494-3069
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About
Features
Specialties
- Hematology & Oncology
Languages spoken
- English
Location
First Address
- Dr. Leroy E Fredericks
- Po Box 122579 Dept 2579
- Dallas, TX
- Zip : 75312-2579
- Fax : (337) 494-3069
- Phone : (337) 494-2919
Second Address
- Dr. Leroy E Fredericks
- 2770 3rd Ave Ste 350
- Lake Charles, LA
- Zip : 70601-0404
- Fax : (337) 494-6811
- Phone : (337) 494-6800
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RH0003X | Hematology & Oncology | MD10005R | LA |
National Provider Identifier
| NPI | 1043335755 |
|---|---|
| Provider Name | Dr. Leroy E Fredericks |
| First Address | Dallas, TX 75312-2579 |
| Second Address | Lake Charles, LA 70601-0404 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/03/2007 |
| Last Update Date | 25/04/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1491217 | (05) | LA |
| 830008368 | RAILROAD MEDICARE (01) | LA |
| G49365 | (02) | LA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.