Provider Demographics
NPI:1023367760
Name:FRAZEE, JEFFREY W (RPH)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:W
Last Name:FRAZEE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 EMILY DR
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-4729
Mailing Address - Country:US
Mailing Address - Phone:864-607-6085
Mailing Address - Fax:
Practice Address - Street 1:507 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-2935
Practice Address - Country:US
Practice Address - Phone:256-381-4311
Practice Address - Fax:256-383-0906
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11486183500000X
NH2488183500000X
AL20176183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist