Provider Demographics
NPI:1164579900
Name:FRISBIE, ROBERT MASON (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MASON
Last Name:FRISBIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9990 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-8183
Mailing Address - Country:US
Mailing Address - Phone:770-649-1857
Mailing Address - Fax:770-968-0727
Practice Address - Street 1:696 MOUNT ZION RD
Practice Address - Street 2:SUITE C-4
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1597
Practice Address - Country:US
Practice Address - Phone:770-968-1746
Practice Address - Fax:770-968-0727
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7334111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJJDMedicare ID - Type Unspecified
GAU94414Medicare UPIN