Provider Demographics
NPI:1811983315
Name:FRISCHE, ERIC E (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:E
Last Name:FRISCHE
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:PO BOX 785
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502
Mailing Address - Country:US
Mailing Address - Phone:580-357-9984
Mailing Address - Fax:580-357-3277
Practice Address - Street 1:110 NW 31ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505
Practice Address - Country:US
Practice Address - Phone:580-357-3671
Practice Address - Fax:580-357-1256
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11095207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100005970AMedicaid
OK4368572OtherAETNA
OK175194700OtherDOL
OK200030294OtherRAILROAD MEDICARE
OK100005970AMedicaid