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NPI 1255049581

NPI 1255049581 : BENJAMIN FRAZIER JAMES : ALBUQUERQUE, NM

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General NPI Number Information
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    NPI Number           |    1255049581
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    Entity Type          |    Individual 
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    Provider Name        |    BENJAMIN FRAZIER JAMES
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/07/2022
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    Last Update Date     |    03/28/2025
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Provider Practice Location Address
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    Address Line         |    2211 LOMAS BLVD NE 
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    City                 |    ALBUQUERQUE
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    State                |    NM
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    Zip                  |    87106-2719
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    Country              |    US
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    Telephone            |    407-495-8671
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    800 BRADBURY DR SE STE 116 
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    City                 |    ALBUQUERQUE
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    State                |    NM
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    Zip                  |    87106-4310
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    Country              |    US
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    Telephone            |    
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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        |    367H00000X
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    Taxonomy Name        |    Anesthesiologist Assistant
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    License Number       |    AA2023-001
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    License Number State |    NM
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