MEDICARE: DR. JOHN ALLEN FRENZ M.D.

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	207T00000X	Neurological Surgery Physician	19263	MS

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

General Provider Information

NPI Number	:	1356568588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ALLEN FRENZ M.D.

Provider Business Mailing Address
First Line	:	13 NORTHTOWN DR
Second Line	:	SUITE 103
City	:	JACKSON
State	:	MS
Zip	:	39211-3047
Country	:	US
Telephone Number	:	601-625-7840
Fax Number	:	769-257-6347

Provider Business Practice Location Address
First Line	:	13 NORTHTOWN DR
Second Line	:	SUITE 103
City	:	JACKSON
State	:	MS
Zip	:	39211-3047
Country	:	US
Telephone Number	:	601-625-7840
Fax Number	:	769-257-6347

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	05/04/2016

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