MEDICARE: TONYA KNOX 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	2084N0400X	Neurology Physician	28451	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SCM4315019	OTHER	SC	MEDICARE PIN

Other Identifiers

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

General Provider Information

NPI Number	:	1952376477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA KNOX FRAZIER MD

Provider Business Mailing Address
First Line	:	PO BOX 743070
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-3070
Country	:	US
Telephone Number	:	864-560-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 SKYLYN DR STE 200
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-1069
Country	:	US
Telephone Number	:	864-560-4500
Fax Number	:

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

Provider Enumeration Date	:	02/19/2006
Last Update Date	:	04/28/2022

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