Provider Demographics
NPI:1366491482
Name:FREIDEN, FLOYD J (MD)
Entity Type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:J
Last Name:FREIDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 NALL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1231
Mailing Address - Country:US
Mailing Address - Phone:913-341-7985
Mailing Address - Fax:913-341-7988
Practice Address - Street 1:6400 PROSPECT AVE
Practice Address - Street 2:SUITE 228
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1100
Practice Address - Country:US
Practice Address - Phone:816-444-5525
Practice Address - Fax:816-444-1947
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7341174400000X
KS0416998174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200644Medicaid
340016724OtherRR MEDICARE
MO06567096OtherBCBS
MOJ713637AMedicare PIN
MO06567096OtherBCBS
340016724OtherRR MEDICARE