Healthcare Provider Details

I. General information

NPI: 1417282138
Provider Name (Legal Business Name): PATRICIA FREIDEL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 DIXIE HWY STE 970
FT WRIGHT KY
41011-2791
US

IV. Provider business mailing address

1717 DIXIE HWY STE 970
FT WRIGHT KY
41011-2791
US

V. Phone/Fax

Practice location:
  • Phone: 859-320-9300
  • Fax: 859-320-9301
Mailing address:
  • Phone: 859-320-9300
  • Fax: 859-320-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number02005609A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.010082
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number03505
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: