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NPI Code Detail

MEDICARE: FREDERICK R WITTEN MD

MEDICARE: FREDERICK R WITTEN 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
1208800000XUrology Physician01040421AIN
2208800000XUrology Physician23489KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00304320OTHERKYRAILROAD MEDICARE
4P00895255OTHERKYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588657654
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICK R WITTEN MD
Provider Business Mailing Address
First Line : 101 HOSPITAL BLVD
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-3769
Country : US
Telephone Number : 812-282-3899
Fax Number : 812-282-4172
Provider Business Practice Location Address
First Line : 101 HOSPITAL BLVD
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-3769
Country : US
Telephone Number : 812-282-3899
Fax Number : 812-282-4172
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2005
Last Update Date : 09/25/2017

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Directions to “ FREDERICK R WITTEN MD” Practice Location

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