Healthcare Provider Details

I. General information

NPI: 1407439763
Provider Name (Legal Business Name): AMY FRAZIER MS, MLS (ASCP)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY CHALL MS, MLS (ASCP)

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 05/04/2021
Certification Date: 05/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11935 ABERCORN ST
SAVANNAH GA
31419-1918
US

IV. Provider business mailing address

341 KENSINGTON DR
SAVANNAH GA
31405-5424
US

V. Phone/Fax

Practice location:
  • Phone: 912-344-3109
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: