Provider Demographics
NPI:1649236647
Name:FRISKEL, ERIC D (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:D
Last Name:FRISKEL
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 1:3470 NE RALPH POWELL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2336
Mailing Address - Country:US
Mailing Address - Phone:913-498-3003
Mailing Address - Fax:913-341-5958
Practice Address - Street 1:3470 NE RALPH POWELL RD
Practice Address - Street 2:SUITE B
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2336
Practice Address - Country:US
Practice Address - Phone:913-498-3003
Practice Address - Fax:913-341-5958
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003000620207RP1001X
KS0425916207RP1001X, 207RS0012X
MO20030000620207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2003000620OtherSTATE LICENSE
KS0425916OtherSTATE LICENSE
MO206045403Medicaid
KS100451700AMedicaid
MO206045403Medicaid
MOMA1666002Medicare PIN
MO2003000620OtherSTATE LICENSE
415C212AMedicare ID - Type Unspecified