Basic Information
| Provider Information | |||||||||
| NPI: | 1699974840 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FREDERICK ALAN DORROH MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 269031 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731269031 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802233216 | ||||||||
| FaxNumber: | 5802234184 | ||||||||
| Practice Location | |||||||||
| Address1: | 2002 12TH AVE NW | ||||||||
| Address2: | STE E | ||||||||
| City: | ARDMORE | ||||||||
| State: | OK | ||||||||
| PostalCode: | 734011227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802233216 | ||||||||
| FaxNumber: | 5802234184 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2007 | ||||||||
| LastUpdateDate: | 07/28/2008 | ||||||||
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| AuthorizedOfficialLastName: | DORROH | ||||||||
| AuthorizedOfficialFirstName: | FREDERICK | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRES | ||||||||
| AuthorizedOfficialTelephone: | 5802233216 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 25721 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.