Basic Information
| Provider Information | |||||||||
| NPI: | 1407945942 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRAZIER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 950202 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402950202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025889490 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 E CHESTNUT ST | ||||||||
| Address2: | SVS BLDG STE 303 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026295552 | ||||||||
| FaxNumber: | 5026293132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2006 | ||||||||
| LastUpdateDate: | 05/10/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 34865 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | 34865 | KY | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 2233577 | 01 | UNITED HEALTH CARE | OTHER | 2948557 | 01 | KY | AETNA HMO ONLY | OTHER | 587286 | 01 | ANTHEM/NORTON | OTHER | P00641375 | 01 | RAILROAD MEDICARE | OTHER | 00533069 | 01 | KY | NMF/KY MEDICARE | OTHER | 64055114 | 05 | KY | MEDICAID | 7134413 | 01 | KY | AETNA | OTHER | 000000332133 | 01 | KY | ANTHEM | OTHER | 2179185 | 01 | FIRST HEALTH | OTHER | 64055114 | 01 | KY | MEDICAID-KY NORTON | OTHER | 50020904 | 01 | PASSPORT/NORTON | OTHER | 200394090 | 01 | IN MAID/NORTON | OTHER | 50004780 | 01 | KY | PASSPORT | OTHER | 6294877 | 01 | KY | CIGNA | OTHER | 2446132000 | 01 | KY | PASSPORT ADVANTAGE | OTHER | 6294877 | 01 | CIGNA/NORTON | OTHER | P00135439 | 01 | MEDICARE RR | OTHER | 099308 | 01 | SIHO/NORTON | OTHER | 200394090 | 05 | IN | MEDICAID |