Provider Demographics
NPI:1548256654
Name:FRAZEE, DAVID THOMAS (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:THOMAS
Last Name:FRAZEE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-1986
Mailing Address - Country:US
Mailing Address - Phone:859-291-4800
Mailing Address - Fax:859-291-4801
Practice Address - Street 1:1025 CENTER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4011
Practice Address - Country:US
Practice Address - Phone:419-289-0491
Practice Address - Fax:419-207-2622
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006384207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2091990Medicaid
OH0856852Medicare PIN
E75906Medicare UPIN