Provider Demographics
NPI:1265656003
Name:FRAZEE, STEPHEN M (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:FRAZEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:773 DENARDS ML SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5153
Mailing Address - Country:US
Mailing Address - Phone:404-822-3781
Mailing Address - Fax:770-439-0198
Practice Address - Street 1:4052 ATLANTA ST
Practice Address - Street 2:SUITE C
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-2693
Practice Address - Country:US
Practice Address - Phone:770-439-0198
Practice Address - Fax:770-439-0297
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR005223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCDBNMedicare ID - Type Unspecified