Jeffrey Don Fry, BHRS
Individual provider Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Stigler, OK
NPI 1659602159 · NPPES record last updated Jan 22, 2010
Key facts
- NPI
- 1659602159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Practice address
- 11730 W Highway 9
Stigler, OK 74462-2468 - Phone
- (918) 635-5158
- NPI assigned
- Jan 22, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
11730 W Highway 9
Stigler, OK 74462-2468
Mailing address
11730 W Highway 9
Stigler, OK 74462-2468
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100746580A | Medicaid | OK |
Other providers in Stigler, OK
- Julie Annette Fioretti
- Esther Fitzgerald
- Mitchel Fitzgerald
- William Franklin
- Aimee Nicole Freeman
- Amy L Garman
- Sidney Joseph Gatzman
- Hannah Gaylord
- Gary D Gentry
- Elizabeth Ann Giddings-Stewart
All providers in Stigler, OK · Mental Health Clinic/Center (Including Community Mental Health Center) in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.