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JONATHAN FREDERICK MD
>> Oral & Maxillofacial Surgery >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1346397239
Individual Registrant: JONATHAN FREDERICK MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
398 ASHE BLVD SHEFFIELD, AL 35660-1729 US
Tel: 256-383-1499 Fax: --
Tel: 256-383-1499 Fax: --
Contact information for business:
398 ASHE BLVD SHEFFIELD, AL 35660-1729 US
Tel: 256-383-1499 Fax: --
Tel: 256-383-1499 Fax: --
Registration Information:
NPI: 1346397239
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 204E00000X | Allopathic & Osteopathic Physicians Oral & Maxillofacial Surgery | AL | AL28212 |
| N | 1223S0112X | Dental Providers Dentist | AL | AL5271 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
