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NPI Code Detail

MEDICARE: ALICE ANNE FRAZIER D.O.

MEDICARE: ALICE ANNE FRAZIER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician34005990FOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000552750OTHEROHANTHEM/BCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000319938OTHERBCBS
4000000528249OTHEROHANTHEM/BCBS

General Provider Information

NPI Number : 1629036496
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE ANNE FRAZIER D.O.
Provider Business Mailing Address
First Line : 4750 HEMPSTEAD STATION DR
Second Line :
City : KETTERING
State : OH
Zip : 45429-5164
Country : US
Telephone Number : 800-875-0136
Fax Number : 937-619-4150
Provider Business Practice Location Address
First Line : 100 DAWN LN
Second Line :
City : WAVERLY
State : OH
Zip : 45690-9138
Country : US
Telephone Number : 740-947-2186
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 11/10/2011

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Directions to “ ALICE ANNE FRAZIER D.O.” Practice Location

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