Healthcare Provider Details

I. General information

NPI: 1275508186
Provider Name (Legal Business Name): BRET N FREY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 N VAN BUREN ST STE A
ENID OK
73703-1729
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE STE 280
OKLAHOMA CITY OK
73112-5555
US

V. Phone/Fax

Practice location:
  • Phone: 580-213-9799
  • Fax: 580-234-2474
Mailing address:
  • Phone: 580-213-9799
  • Fax: 580-234-2474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number18928
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: