Dalton Frederick, OTD, OTR/L | |
6300 E Lake Blvd Ste 101, Vancleave, MS 39565-6771 | |
(228) 215-2240 | |
(228) 215-2241 |
Full Name | Dalton Frederick |
---|---|
Gender | Male |
Speciality | Occupational Therapist |
Location | 6300 E Lake Blvd Ste 101, Vancleave, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811776701 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OT-4052 (Mississippi) | Primary |
Provider Name | Bienville Orthopaedic Specialists, Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1689605834 PECOS PAC ID: 0547155178 Enrollment ID: O20040220000834 |
Mailing Address | Practice Location Address |
---|---|
Dalton Frederick, OTD, OTR/L 6300 E Lake Blvd Ste 301, Vancleave, MS 39565-6771 Ph: (228) 230-2663 | Dalton Frederick, OTD, OTR/L 6300 E Lake Blvd Ste 101, Vancleave, MS 39565-6771 Ph: (228) 215-2240 |
Clarissa Picard, OCCUPATIONAL THERAPI Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 6300 East Lake Blvd., Suite 301, Vancleave, MS 39565 Phone: 228-230-2663 Fax: 228-206-1130 | |
Jayme Robinson, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4700 Colonel Vickrey Road, Vancleave, MS 39565 Phone: 228-826-1757 | |
Mrs. Karoline G Johnson, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 16425 Highway 57, Vancleave, MS 39565 Phone: 228-990-2476 | |
Mrs. Melissa Nolan Hartsfield, Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 6300 E Lake Blvd Ste 101, Vancleave, MS 39565 Phone: 228-215-2240 Fax: 228-215-2241 | |
Julia G. Hines, O.T. Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 2109 Holder Rd, Vancleave, MS 39565 Phone: 228-826-3059 Fax: 228-826-3059 |