Healthcare Provider Details

I. General information

NPI: 1467430702
Provider Name (Legal Business Name): GEORGE THOMAS FRAZIER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S MCKINLEY ST SUITE 200
LITTLE ROCK AR
72205-5202
US

IV. Provider business mailing address

600 S MCKINLEY ST SUITE 200
LITTLE ROCK AR
72205-5202
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-4088
  • Fax: 501-664-7113
Mailing address:
  • Phone: 501-664-4088
  • Fax: 501-664-7113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberC6163
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: