Provider Demographics
NPI:1447298385
Name:FREY, TIMOTHY C (DO)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:C
Last Name:FREY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:5601 N. ANTIOCH
Practice Address - Street 2:CREEKWOOD FAMILY CARE, STE. 12
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64119
Practice Address - Country:US
Practice Address - Phone:816-452-8000
Practice Address - Fax:816-455-2383
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2009-11-03
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Provider Licenses
StateLicense IDTaxonomies
MOR7C61207Q00000X
KS05-19466207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
10001637501OtherCHP PIC HILLS
1186358OtherAETNA PICS HILLS UC
2057247OtherAETNA CFC
3732650OtherAETNA KUMW UC
39415017OtherWW URGENT CARE
481159444OtherJAYHAWK TAX ID
10001637500OtherCHP CFC
11207011OtherBCBS CFC
157695XXOtherPREFERRED CARE OF NY
22039026OtherBCBS PIC HILLS UC
25562039OtherBCBS KUMW UC
18960020OtherCFU BCBS
KS100391550AMedicaid
KS080171268OtherRR MEDICARE
326933OtherFIRSTGUARD KUMW UC
3732650OtherAETNA KUMW UC
KS100391550AMedicaid
KS080171268OtherRR MEDICARE