Provider Demographics
NPI:1912907379
Name:FRECHETTE, LINDA A (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:A
Last Name:FRECHETTE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-1239
Mailing Address - Country:US
Mailing Address - Phone:317-736-7715
Mailing Address - Fax:317-736-5976
Practice Address - Street 1:951 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-1239
Practice Address - Country:US
Practice Address - Phone:317-736-7715
Practice Address - Fax:317-736-5976
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ININ1921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100153620Medicaid
IN439420AMedicare ID - Type Unspecified
INT34814Medicare UPIN