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NPI Code Detail

MEDICARE: DR. SUSAN J FRAZIER MD

MEDICARE: DR. SUSAN J FRAZIER 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
1207Q00000XFamily Medicine Physician34972WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184606469
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN J FRAZIER MD
Provider Business Mailing Address
First Line : 1700 W STOUT ST
Second Line :
City : RICE LAKE
State : WI
Zip : 54868-5000
Country : US
Telephone Number : 715-236-8100
Fax Number :
Provider Business Practice Location Address
First Line : 1700 W STOUT ST
Second Line :
City : RICE LAKE
State : WI
Zip : 54868-5000
Country : US
Telephone Number : 715-236-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 04/22/2024

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