MEDICARE: DR. ALLEYN EMORY FRIEDRICH SR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	044460	GA

General Provider Information

NPI Number	:	1093736662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLEYN EMORY FRIEDRICH SR. MD

Provider Business Mailing Address
First Line	:	4233 HIGHWAY 8
Second Line	:
City	:	LEESVILLE
State	:	LA
Zip	:	71446-0213
Country	:	US
Telephone Number	:	337-383-7262
Fax Number	:

Provider Business Practice Location Address
First Line	:	1535 3RD ST
Second Line	:	#285
City	:	FT POLK
State	:	LA
Zip	:	71459
Country	:	US
Telephone Number	:	337-531-2344
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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