Provider Demographics
NPI:1134140817
Name:FRASER, ERIC A (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:A
Last Name:FRASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 SPRINGHILL DR
Mailing Address - Street 2:SUITE 245
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2924
Mailing Address - Country:US
Mailing Address - Phone:501-758-1530
Mailing Address - Fax:501-758-5371
Practice Address - Street 1:3401 SPRINGHILL DR
Practice Address - Street 2:SUITE 245
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2924
Practice Address - Country:US
Practice Address - Phone:501-758-1530
Practice Address - Fax:501-758-5371
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4815208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR51772OtherBLUE CROSS BLUE SHIELD #
AR51772Medicare ID - Type Unspecified
AR51772OtherBLUE CROSS BLUE SHIELD #