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1033179163

NPI Code Detail

MEDICARE: DR. ERIC ELLIS FRYXELL MD

MEDICARE: DR. ERIC ELLIS FRYXELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35-077709	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	341425870042	OTHER	OH	MEDICAL MUTUAL OF OHIO
3	264200000	OTHER	OH	FEDERAL BLACK LUNG
4	000000341594	OTHER	OH	ANTHEM
5	80507	OTHER	OH	QUALCHOICE
6	6600162	OTHER	OH	UNITED HEALTHCARE
7	264200000	OTHER	OH	DEPT OF LABOR

General Provider Information

NPI Number	:	1033179163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC ELLIS FRYXELL MD

Provider Business Mailing Address
First Line	:	1180 E MAIN ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1902
Country	:	US
Telephone Number	:	614-645-1900
Fax Number	:	614-645-5517

Provider Business Practice Location Address
First Line	:	1180 E MAIN ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1902
Country	:	US
Telephone Number	:	614-645-5535
Fax Number	:	614-645-5546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	10/31/2017

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Directions to “ DR. ERIC ELLIS FRYXELL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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