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General NPI Number Information
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NPI Number | 1417277278
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Entity Type | Organization
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Legal Business Name | CHARLES FRAZIER INC
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 411 PARKWAY STE E
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City | GREENSBORO
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State | NC
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Zip | 27401-1644
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Country | US
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Telephone | 336-274-0168
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Fax | 336-274-0340
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Provider Business Mailing Address
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Address Line | 411 PARKWAY STE E
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City | GREENSBORO
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State | NC
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Zip | 27401-1644
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Country | US
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Telephone | 336-274-0168
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Fax | 336-274-0340
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CHARLES EARL FRAZIER
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Credential | M.D.
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Telephone | 336-274-0168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 018159
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License Number State | NC
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