ANDRE FREDIEU (NPI# 1578543260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578543260 |
| Entity Type | Individual |
| Full Name | ANDRE FREDIEU |
| Credential | MD |
| Practice Address |
1245 S Utica Ave 3rd Floor West Tulsa OK 74104-4214 |
| Practice Telephone | 9185603823 |
| Practice Fax Number | 9185792535 |
| Mailing Telephone | 9185603823 |
| Mailing Fax Number | 9185792535 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2015-08-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
31365 | OK | Allopathic & Osteopathic Physicians |
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
P5364 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 3810002589 | 05 | |
| VA | 010176026 | 05 | |
| VA | MOUNTAIN STATE BCBS | 001746276 | 01 |
| VA | ANTHEM BCBS | 180288 | 01 |
| OK | 200590450A | 05 | |
| VA | RAILROAD MEDICARE | P00235877 | 01 |
| Street Address |
1245 S UTICA AVE 3RD FLOOR WEST |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356721237 | Devon Morris | Nurse Practitioner | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2015-06-04 |
| 1124426978 | Helen Hoggard | Registered Nurse | 1245 S Utica Ave, 2nd Floor East, Tulsa, OK 74104-4214 | 2014-12-10 |
| 1306264676 | Amy Clark | Nurse Practitioner | 1245 S Utica Ave, 3rd Floor West, Tulsa, OK 74104-4214 | 2014-04-02 |
| 1811314909 | Brandi Baxter | Nurse Practitioner | 1245 S Utica Ave, Suite 103, Tulsa, OK 74104-4214 | 2014-03-26 |
| 1649612847 | Laura Thornton Bloomfield | Nurse Practitioner | 1245 S Utica Ave, 2nd Floor West, Tulsa, OK 74104-4214 | 2013-07-29 |
| 1669745667 | Amara Gayathri Nandikolla | Internal Medicine | 1245 S Utica Ave, Ste 100, Tulsa, OK 74104 | 2012-02-22 |
| 1659539401 | Hillary Pane | Family Medicine | 1245 S Utica Ave, 2w, Tulsa, OK 74104-4214 | 2008-05-29 |
| 1003001785 | Jaclyn Cinda Jones | Orthopaedic Surgery | 1245 S Utica Ave, Tulsa, OK 74104 | 2007-09-06 |
| 1629283114 | Ahs Oklahoma Physician Group, LLC | Internal Medicine | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2007-05-10 |
| 1477766616 | Andrea Elizabeth Stafford | Internal Medicine | 1245 S Utica Ave, Tulsa, OK 74104-4214 | 2007-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386980811 | L Keith Simmons Do Pllc | Psychiatry & Neurology | 7951 S Hudson Pl, Tulsa, OK 74136-8458 | 2013-01-03 |
| 1740541473 | Jaclyn Duvall | Psychiatry & Neurology | 9001 S 101st East Ave Ste 300, Tulsa, OK 74133-5796 | 2012-05-29 |
| 1295046084 | Vijay Mahadev Pandav | Psychiatry & Neurology | 6151 S Yale Ave Ste 1303, Tulsa, OK 74136-1907 | 2010-06-25 |
| 1144457862 | Michael J. Haugh | Psychiatry & Neurology | 3708 E 47th Pl, Tulsa, OK 74135-1912 | 2009-06-20 |
| 1558595165 | Interpreting Services Group LLC | Psychiatry & Neurology | 5563 S Lewis, Suite #100, Tulsa, OK 74105-7103 | 2009-05-11 |
| 1447447487 | Jeremy Salas | Psychiatry & Neurology | 1919 S Wheeling Ave Ste 707, Tulsa, OK 74104-5636 | 2007-10-03 |
| 1316143621 | Tania Alejandra Reyna | Psychiatry & Neurology | 9001 S 101st East Ave Ste 190, Tulsa, OK 74133-5799 | 2007-06-23 |
| 1073650537 | Anna Wanahita | Psychiatry & Neurology | 2626 E 35th St, Tulsa, OK 74105 | 2007-01-31 |
| 1396808648 | Ord Jehu Mitchell | Psychiatry & Neurology | 5533 E 107th Pl, Tulsa, OK 74137-7090 | 2006-12-18 |
| 1043224264 | Jay Kevin Johnson | Psychiatry & Neurology | 7134 S Yale Ave Ste 450, Tulsa, OK 74136-6380 | 2006-07-27 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.