Healthcare Provider Details

I. General information

NPI: 1235130451
Provider Name (Legal Business Name): RONALD D. FRAZIER M.D. FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N. SANDUSKY AVENUE
BUCYRUS OH
44820-1463
US

IV. Provider business mailing address

5350 FRANTZ RD
DUBLIN OH
43016-4259
US

V. Phone/Fax

Practice location:
  • Phone: 419-562-4966
  • Fax: 419-562-5119
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35049100
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: