Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark R. Frederick, DO

Individual provider Anesthesiology Physician · NPI 1063407609

Mark R. Frederick, DO is an Anesthesiology Physician in Jefferson City, Missouri. Licensed in Missouri. Registered with an NPI since 2005.

Licensed in
MO
In the registry since
2005
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1445 Christy Dr
Jefferson City, MO 65101-2853
Phone: (573) 636-3483
Fax: (573) 636-5315
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence R8B46 (MO)

Record details

NPI number1063407609
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedSeptember 20, 2005
Last updated in NPPESOctober 15, 2007
Mailing address1445 Christy Dr, Jefferson City, MO 65101-2853

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