Healthcare Provider Details

I. General information

NPI: 1023367760
Provider Name (Legal Business Name): JEFFREY W FRAZEE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 N COLUMBIA AVE
SHEFFIELD AL
35660-2935
US

IV. Provider business mailing address

121 EMILY DR
MUSCLE SHOALS AL
35661-4729
US

V. Phone/Fax

Practice location:
  • Phone: 256-381-4311
  • Fax: 256-383-0906
Mailing address:
  • Phone: 864-607-6085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11486
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2488
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20176
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: