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General NPI Number Information
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NPI Number | 1093736662
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Entity Type | Individual
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Provider Name | ALLEYN EMORY FRIEDRICH SR. MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1535 3RD ST #285
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City | FT POLK
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State | LA
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Zip | 71459
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Country | US
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Telephone | 337-531-2344
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Fax |
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Provider Business Mailing Address
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Address Line | 4233 HIGHWAY 8
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City | LEESVILLE
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State | LA
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Zip | 71446-0213
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Country | US
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Telephone | 337-383-7262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 044460
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License Number State | GA
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