Healthcare Provider Details

I. General information

NPI: 1073500609
Provider Name (Legal Business Name): JOSEPH G FRECHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10844 N 23RD AVE STE 200
PHOENIX AZ
85029-4947
US

IV. Provider business mailing address

202 E EARLL DR STE 200
PHOENIX AZ
85012-2647
US

V. Phone/Fax

Practice location:
  • Phone: 602-808-2800
  • Fax: 505-439-2860
Mailing address:
  • Phone: 602-808-2800
  • Fax: 505-439-2860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number53150
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number9352
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: