Provider Demographics
NPI:1114296746
Name:FRASER FAMILY MEDICINE, P.C.
Entity Type:Organization
Organization Name:FRASER FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-488-7070
Mailing Address - Street 1:2641 S 70TH ST
Mailing Address - Street 2:STE A
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2912
Mailing Address - Country:US
Mailing Address - Phone:402-488-7070
Mailing Address - Fax:402-327-8768
Practice Address - Street 1:2641 S 70TH ST
Practice Address - Street 2:STE A
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2912
Practice Address - Country:US
Practice Address - Phone:402-488-7070
Practice Address - Fax:402-327-8768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty