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General NPI Number Information
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NPI Number | 1962460519
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Entity Type | Individual
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Provider Name | DOUGLAS LYNN FRIESEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 2708 S RIFE MEDICAL LN STE T40
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City | ROGERS
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State | AR
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Zip | 72758-1474
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Country | US
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Telephone | 479-878-2550
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Fax | 479-878-2555
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Provider Business Mailing Address
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Address Line | PO BOX 1515
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City | DURANT
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State | OK
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Zip | 74702-1515
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Country | US
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Telephone | 580-920-2525
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Fax | 580-924-2305
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | N8205
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License Number State | AR
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