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General NPI Number Information
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NPI Number | 1205966256
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Entity Type | Individual
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Provider Name | THOMAS HALL FRAZIER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 03/26/2012
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Provider Practice Location Address
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Address Line | 32 PROFESSIONAL PARK DR SUITE 108
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City | LOUISA
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State | KY
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Zip | 41230-9644
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Country | US
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Telephone | 606-638-4656
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Fax | 606-638-4658
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Provider Business Mailing Address
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Address Line | PO BOX 30
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City | LOUISA
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State | KY
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Zip | 41230-0030
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Country | US
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Telephone | 606-638-1154
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R1271
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 41998
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License Number State | KY
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