MEDICARE: DR. LAWRENCE JOSEPH FRERKER 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	29008	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	29008	OTHER	CO	29008

General Provider Information

NPI Number	:	1326029992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE JOSEPH FRERKER MD

Provider Business Mailing Address
First Line	:	7363 S COSTILLA CT
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80120-3903
Country	:	US
Telephone Number	:	303-888-2574
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 W HAMPDEN PL STE 260
Second Line	:
City	:	ENGLEWOOD
State	:	CO
Zip	:	80110-2471
Country	:	US
Telephone Number	:	720-639-9884
Fax Number	:	720-390-5188

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	05/04/2022

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