Barry L. Frederick, PA-C, MPAS, RN, BSN
Physician Assistant, Medical in Slidell, LA. Individual provider (NPI-1).
NPI number1285601740
StatusActive
Last updated in NPPESApr 22, 2020
Details
- NPI
- 1285601740
- Entity type
- Individual (NPI-1)
- Name
- Barry L. Frederick
- Credential
- PA-C, MPAS, RN, BSN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 3, 2006
- Certification date
- Apr 22, 2020
- Last updated
- Apr 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
| 363A00000X | Physician Assistant | A10586 | LA |
Practice location
1150 Robert Blvd Ste 240Slidell, LA 70458-2005
Phone 985-646-3662 · Fax 985-646-3691
Mailing address
1001 Gause Blvd # 75Slidell, LA 70458-2939
Other practice locations
1001 Gause Blvd
Slidell, LA 70458-2939
Slidell, LA 70458-2939
Phone 985-649-8542
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