1871972067 NPI number — ROBERT WILLIAM FREILICH M.D. - P.H.D

Table of content: ROBERT WILLIAM FREILICH M.D. - P.H.D (NPI 1871972067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871972067 NPI number — ROBERT WILLIAM FREILICH M.D. - P.H.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FREILICH
Provider First Name:
ROBERT
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D. - P.H.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871972067
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 1ST AVE3911 AVE B, SUITE 1110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSBLUFF
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
69361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-630-2101
Provider Business Mailing Address Fax Number:
308-630-2139

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
740 S LIMESTONE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-6402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-6700
Provider Business Practice Location Address Fax Number:
859-257-1331
Provider Enumeration Date:
05/21/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  302123 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X , with the licence number: 37273 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RR0500X , with the licence number: 58816 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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