Healthcare Provider Details

I. General information

NPI: 1497719199
Provider Name (Legal Business Name): JAMES FRECKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 AUBURN AVE STE 334
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

2123 AUBURN AVE STE 334
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-1500
  • Fax: 513-585-1510
Mailing address:
  • Phone: 513-585-1500
  • Fax: 513-585-1510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35066299F
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: