Provider Demographics
NPI:1609254531
Name:JOHN C. FRIEDL, INC
Entity type:Organization
Organization Name:JOHN C. FRIEDL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRIEDL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-291-2323
Mailing Address - Street 1:13809 S CASPER ST STE D
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-2619
Mailing Address - Country:US
Mailing Address - Phone:918-291-2323
Mailing Address - Fax:918-291-2320
Practice Address - Street 1:13809 S CASPER ST STE D
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-2619
Practice Address - Country:US
Practice Address - Phone:918-291-2323
Practice Address - Fax:918-291-2320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2743207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty