Healthcare Provider Details

I. General information

NPI: 1871693952
Provider Name (Legal Business Name): AMY JOHANNA FRAZIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 W NORTHERN AVE
PHOENIX AZ
85021-4936
US

IV. Provider business mailing address

3623 CROSSINGS DR STE 297
PRESCOTT AZ
86305-7101
US

V. Phone/Fax

Practice location:
  • Phone: 205-964-2924
  • Fax:
Mailing address:
  • Phone: 602-277-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberWY16513C
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number28774
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: