Healthcare Provider Details

I. General information

NPI: 1235137746
Provider Name (Legal Business Name): JAMES FREDRICK FROMMER JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date: 03/15/2006
Reactivation Date: 03/29/2006

III. Provider practice location address

125 CARSON VALLEY RD
DUNCANSVILLE PA
16635-8055
US

IV. Provider business mailing address

125 CARSON VALLEY RD
DUNCANSVILLE PA
16635-8055
US

V. Phone/Fax

Practice location:
  • Phone: 582-465-7008
  • Fax:
Mailing address:
  • Phone: 582-465-7008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number009673-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: