Provider Demographics
NPI:1285778266
Name:FRICKE, JEFFREY ALLEN (DC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALLEN
Last Name:FRICKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 W LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-2531
Mailing Address - Country:US
Mailing Address - Phone:336-885-1987
Mailing Address - Fax:336-885-1992
Practice Address - Street 1:137 W LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-2531
Practice Address - Country:US
Practice Address - Phone:336-885-1987
Practice Address - Fax:336-885-1992
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1525111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08432OtherBCBS
NC428240Medicaid
NC08432OtherBCBS
NCT64514Medicare UPIN