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General NPI Number Information
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NPI Number | 1477592590
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Entity Type | Individual
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Provider Name | A GERALD FROST
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 04/10/2014
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Provider Practice Location Address
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Address Line | 824 MAIN ST SUITE 206, MOB 1
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-4478
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Country | US
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Telephone | 610-983-1715
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Fax | 610-422-5442
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Provider Business Mailing Address
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Address Line | 824 MAIN ST SUITE 206, MOB 1
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-4478
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Country | US
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Telephone | 610-983-1715
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Fax | 610-422-5442
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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 | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | MD027125E
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License Number State | PA
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