MEDICARE: ERIN RICHEY 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
1	208000000X	Pediatrics Physician	37997	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000950945	OTHER	KY	ANTHEM - NCMA
2	50094241	OTHER	KY	PASSPORT - NCMA
3	072195	OTHER	KY	SIHO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881697712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN RICHEY FRAZIER MD

Provider Business Mailing Address
First Line	:	PO BOX 776879
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6879
Country	:	US
Telephone Number	:	502-272-5395
Fax Number	:	502-272-5116

Provider Business Practice Location Address
First Line	:	230 E BROADWAY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-2026
Country	:	US
Telephone Number	:	502-629-8990
Fax Number	:	502-394-3604

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	04/06/2021

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