MEDICARE: DR. AMY JOHANNA FRAZIER MD

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
1	2084P0800X	Psychiatry Physician	WY16513C	WY
2	2084P0805X	Geriatric Psychiatry Physician	28774	AZ

General Provider Information

NPI Number	:	1871693952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY JOHANNA FRAZIER MD

Provider Business Mailing Address
First Line	:	3623 CROSSINGS DR STE 297
Second Line	:
City	:	PRESCOTT
State	:	AZ
Zip	:	86305-7101
Country	:	US
Telephone Number	:	602-277-5551
Fax Number	:

Provider Business Practice Location Address
First Line	:	2255 W NORTHERN AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4936
Country	:	US
Telephone Number	:	205-964-2924
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	08/06/2025

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