Healthcare Provider Details

I. General information

NPI: 1730140617
Provider Name (Legal Business Name): DAVID HUGH FRAZER JR. M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 12/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 NARROW LANE PKWY
MONTGOMERY AL
36111-2654
US

IV. Provider business mailing address

1420 NARROW LANE PKWY
MONTGOMERY AL
36111-2654
US

V. Phone/Fax

Practice location:
  • Phone: 334-284-4196
  • Fax: 334-284-4256
Mailing address:
  • Phone: 334-284-4196
  • Fax: 334-284-4256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number3006
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: