Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 30008 | AL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 30008 | AL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 30008 | AL |
NPI | 1194911537 |
---|---|
Provider Name | Timothy Lee Frerichs |
First Address | Mobile, AL 36689-6144 |
Second Address | Foley, AL 36535-2249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2007 |
Last Update Date | 05/06/2015 |