Healthcare Provider Details

I. General information

NPI: 1508607672
Provider Name (Legal Business Name): WHITNEY FRICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 W 6TH AVE
STILLWATER OK
74074-4399
US

IV. Provider business mailing address

6820 THE CEDARS UNIT A
STILLWATER OK
74074-8293
US

V. Phone/Fax

Practice location:
  • Phone: 405-784-5842
  • Fax:
Mailing address:
  • Phone: 602-872-6678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number43394
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: